All Men with Vasculogenic Erectile Dysfunction Require a Cardiovascular Workup

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• 作者：Martin Miner ; Ajay Nehra ; Graham Jackson ; Shalender Bhasin ; Kevin Billups ; Arthur L. Burnett ; Jacques Buvat ; Culley Carson ; Glenn Cunningham ; Peter Ganz ; Irwin Goldstein ; Andre Guay ; Geoff Hackett ; Robert A. Kloner ; John B. Kostis ; K. Elizabeth LaFlamme ; Piero Montorsi ; Melinda Ramsey ; Raymond Rosen ; Richard Sadovsky ; Allen Seftel ; et al.
• 关键词：Cardiovascular disease ; Erectile dysfunction ; Evaluation
• 刊名：The American Journal of Medicine
• 出版年：March, 2014
• 年：2014
• 卷：127
• 期：3
• 页码：174-182
• 全文大小：436 K

文摘

An association between erectile dysfunction and cardiovascular disease has long been recognized, and studies suggest that erectile dysfunction is an independent marker of cardiovascular disease risk. Therefore, assessment and management of erectile dysfunction may help identify and reduce the risk of future cardiovascular events, particularly in younger men. The initial erectile dysfunction evaluation should distinguish between predominantly vasculogenic erectile dysfunction and erectile dysfunction of other etiologies. For men believed to have predominantly vasculogenic erectile dysfunction, we recommend that initial cardiovascular risk stratification be based on the Framingham Risk Score. Management of men with erectile dysfunction who聽are at low risk for cardiovascular disease should focus on risk-factor control; men at high risk, including those with cardiovascular symptoms, should be referred to a cardiologist. Intermediate-risk men should undergo noninvasive evaluation for subclinical atherosclerosis. A growing body of evidence supports the use of emerging prognostic markers to further understand cardiovascular risk in men with erectile dysfunction, but few markers have been prospectively evaluated in this population. In conclusion, we support cardiovascular risk stratification and risk-factor management in all men with vasculogenic erectile dysfunction.