title: Basic Science Evidence for the Link Between Erectile Dysfunction and Cardiometabolic Dysfunction.
abstract: BACKGROUND
  Although clinical evidence supports an association between cardiovascular/metabolic diseases (CVMD) and erectile dysfunction (ED), scientific evidence for this link is incompletely elucidated.
  
  
  OBJECTIVE
  This study aims to provide scientific evidence for the link between CVMD and ED.
  
  
  METHODS
  In this White Paper, the Basic Science Committee of the Sexual Medicine Society of North America assessed the current literature on basic scientific support for a mechanistic link between ED and CVMD, and deficiencies in this regard with a critical assessment of current preclinical models of disease.
  
  
  RESULTS
  A link exists between ED and CVMD on several grounds: the endothelium (endothelium-derived nitric oxide and oxidative stress imbalance); smooth muscle (SM) (SM abundance and altered molecular regulation of SM contractility); autonomic innervation (autonomic neuropathy and decreased neuronal-derived nitric oxide); hormones (impaired testosterone release and actions); and metabolics (hyperlipidemia, advanced glycation end product formation).
  
  
  CONCLUSIONS
  Basic science evidence supports the link between ED and CVMD. The Committee also highlighted gaps in knowledge and provided recommendations for guiding further scientific study defining this risk relationship. This endeavor serves to develop novel strategic directions for therapeutic interventions.
authors.affiliation: The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Biljana
authors.initials: B
authors.lastname: Musicki
authors.affiliation: Division of Urology, Department of Surgery and Department of Neuroscience, Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, ON, Canada.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Bella
authors.affiliation: The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Trinity J
authors.initials: TJ
authors.lastname: Bivalacqua
authors.affiliation: Department of Urology, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Kelvin P
authors.initials: KP
authors.lastname: Davies
authors.affiliation: Department of Surgery/Division of Urology, Cooper University Hospital, Camden, NJ, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: DiSanto
authors.affiliation: Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA.|Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Nestor F
authors.initials: NF
authors.lastname: Gonzalez-Cadavid
authors.affiliation: Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors.forename: Johanna L
authors.initials: JL
authors.lastname: Hannan
authors.affiliation: Institute for Sexual Medicine, San Diego, CA, USA.
authors.forename: Noel N
authors.initials: NN
authors.lastname: Kim
authors.affiliation: Departments of Urology, Physiology, and Bioengineering, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Podlasek
authors.affiliation: Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Wingard
authors.affiliation: The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Burnett
mesh_terms: D000375:Aging; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D007172:Erectile Dysfunction / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism / Q000503:physiopathology*; D009130:Muscle, Smooth / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology; D010413:Penis / Q000098:blood supply*; D012307:Risk Factors; D015398:Signal Transduction; D013739:Testosterone / Q000627:therapeutic use
chemical_list: D009569:Nitric Oxide; D013739:Testosterone
keywords: Autonomic Regulation; Endothelium; Hormones; Metabolics; Smooth Muscle