Subclinical Coronary Artery Atherosclerosis in Patients With Erectile Dysfunction

Chiurlia, Emilio; D’Amico, Roberto; Ratti, Carlo; Granata, Antonio R. M.; Romagnoli, Renato; Modena, Maria Grazia

doi:10.1016/j.jacc.2005.06.068

Cited by 200 publications

(154 citation statements)

References 18 publications

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“…8 Men with ED with and without obesity have higher levels of C-reactive protein compared to men with normal erectile function. 6,7,9 Tumor necrosis factor-a, interleukin-6, C-reactive protein and reactive oxygen species all cause insulin resistance. Insulin is an integral stimulator of vascular NO and thereby increased skeletal muscle glucose disposal.…”

Section: Weight Lossmentioning

confidence: 99%

“…flow-mediated dilation (FMD) was 2.4±0.21% in the men with ED compared with 3.9 ± 0.26% in the men without ED (Po0.001). 7 This review will discuss various lifestyle and metabolic factors influencing vascular NO and erectile function, with an emphasis on the role of oxidative stress and inflammation, and specific interventions available to maximize erectile and vascular health.…”

Section: Introductionmentioning

confidence: 99%

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Lifestyle and metabolic approaches to maximizing erectile and vascular health

et al. 2011

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Oxidative stress and inflammation, which disrupt nitric oxide (NO) production directly or by causing resistance to insulin, are central determinants of vascular diseases including ED. Decreased vascular NO has been linked to abdominal obesity, smoking and high intakes of fat and sugar, which all cause oxidative stress. Men with ED have decreased vascular NO and circulating and cellular antioxidants. Oxidative stress and inflammatory markers are increased in men with ED, and all increase with age. Exercise increases vascular NO, and more frequent erections are correlated with decreased ED, both in part due to stimulation of endothelial NO production by shear stress. Exercise and weight loss increase insulin sensitivity and endothelial NO production. Potent antioxidants or high doses of weaker antioxidants increase vascular NO and improve vascular and erectile function. Antioxidants may be particularly important in men with ED who smoke, are obese or have diabetes. Omega-3 fatty acids reduce inflammatory markers, decrease cardiac death and increase endothelial NO production, and are therefore critical for men with ED who are under age 60 years, and/or have diabetes, hypertension or coronary artery disease, who are at increased risk of serious or even fatal cardiac events. Phosphodiesterase inhibitors have recently been shown to improve antioxidant status and NO production and allow more frequent and sustained penile exercise. Some angiotensin II receptor blockers decrease oxidative stress and improve vascular and erectile function and are therefore preferred choices for lowering blood pressure in men with ED. Lifestyle modifications, including physical and penile-specific exercise, weight loss, omega-3 and folic acid supplements, reduced intakes of fat and sugar, and improved antioxidant status through diet and/or supplements should be integrated into any comprehensive approach to maximizing erectile function, resulting in greater overall success and patient satisfaction, as well as improved vascular health and longevity.

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Section: Weight Lossmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lifestyle and metabolic approaches to maximizing erectile and vascular health

et al. 2011

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“…21,22 ED can be an early marker for atherosclerosis, cardiovascular risk and subclinical vascular pathology. 17,19,20,23 It can also be predictive of the presence and extent of subclinical atherosclerosis, independent of traditional risk factors. 21 The overall ED prevalence in men with coronary artery disease seems to be high.…”

Section: Introductionmentioning

confidence: 99%

The prevalence and associations of erectile dysfunction in a South African male diabetic urban population

Kemp

Rheeder

2015

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Background: Erectile dysfunction (ED) is a common condition in patients with type 1 or type 2 diabetes mellitus. The prevalence and predictors in our patient population are unknown since minimal data exist for this condition in South Africa. Method: An observational, cross-sectional study was performed on 150 consecutive male patients aged ≥ 50 years, with either type 1 or type 2 diabetes mellitus, attending the Steve Biko Academic Hospital Diabetes Clinic. These patients were evaluated for diabetes mellitus control and medical complications, and for the presence of ED. Morning serum testosterone levels were determined. Results: Some degree of ED was reported in 95% of the patients, with 51% reporting serious dysfunction. Using multivariate logistic regression, it was determined that the significant factors associated with ED were age, body mass index, the peripheral neuropathy score and diuretic therapy. Differences in quality-of-life scores were seen in some ED subgroups. Conclusion: This study confirms the high prevalence of ED in diabetic male patients in a tertiary setting. It is suggested that universal screening should be performed for this population group. Multiple predictors of ED were identified in this study. ED negatively affected quality of life, but not in a statistically significant way.

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“…Kaiser et al 29 were able to demonstrate worsened FMD in 30 men with ED without manifest CAD. Chiurla et al 80 had similar findings in 70 men with ED, as opposed to better endothelial function in 73 men without ED, again in patients without manifest CAD (although results also correlated with higher calcium scores). In addition, Yavuzgil et al 81 found vasculogenic ED to be associated with impaired FMD.…”

Section: Physiological Measurementsmentioning

confidence: 76%

Assessment of endothelial function in the patient with erectile dysfunction: an opportunity for the urologist

Tamler

Bar‐Chama

2008

Int J Impot Res

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Although there is now ample evidence that men with manifest coronary, cerebral and peripheral vascular disease and their risk factors are at highest risk for suffering from erectile dysfunction, recent findings demonstrate a strong connection between erectile dysfunction and endothelial dysfunction. This review explores how urologists and other providers may utilize the link between these conditions in clinical practice, compares methods of assessing endothelial dysfunction and finally speculates on how this additional information might impact treatment plans.

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Subclinical Coronary Artery Atherosclerosis in Patients With Erectile Dysfunction

Cited by 200 publications

References 18 publications

Lifestyle and metabolic approaches to maximizing erectile and vascular health

Lifestyle and metabolic approaches to maximizing erectile and vascular health

The prevalence and associations of erectile dysfunction in a South African male diabetic urban population

Assessment of endothelial function in the patient with erectile dysfunction: an opportunity for the urologist

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