The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

Osondu, Chukwuemeka U.; Vo, Bryan; Oni, Ebenezer; Blaha, Michael J.; Veledar, Emir; Feldman, Theodore; Agatston, Arthur S.; Nasir, Khurram; Aneni, Ehimen

doi:10.1177/1358863x17725809

Cited by 50 publications

(28 citation statements)

References 62 publications

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“…Although it is now recognized that ED, and in particular vasculogenic ED, might precede clinical symptoms of CVD (Dong et al ., ; Yamada et al ., ; Fan et al ., ; Osondu et al ., ; Uddin et al ., ), the exact role of P‐CDU parameters in estimating the future risk of CVD is not clear. Corona et al .…”

Section: Discussionmentioning

confidence: 99%

“…These deleterious factors result in common underlying mechanism, among which inflammation, atherosclerosis and endothelial dysfunction are major contributors (Bivalacqua et al ., ; Solomon et al ., ; Fung et al ., ; Grover et al ., ; Hamilton & Watts, ). At least four meta‐analyses have confirmed the relationship between arteriogenic ED and CV risk (Dong et al ., ; Yamada et al ., ; Fan et al ., ; Osondu et al ., ). All this evidence suggests that vasculogenic ED can be a harbinger for early CVD (Foresta et al ., ; Uddin et al ., ; Zhao & Zhang, ).…”

Section: Introductionmentioning

confidence: 97%

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Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

et al. 2018

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Background: Traditional risk factors used to assess cardiovascular risk miss a significant population who are indeed at risk for future cardiac events. Erectile dysfunction (ED) is an emerging marker for future cardiovascular disease (CVD) and major adverse cardiovascular events (MACE), especially in young and middle-aged men with vasculogenic ED. Cavernous arteries morphological alterations at penile colour doppler ultrasound (P-CDU) are used to find a vasculogenic ED. Objectives: We investigated the possible relationship between cavernous arteries morphological alterations at P-CDU assessment and future MACE. Materials and methods: We conducted a retrospective cohort study involving 300 ED patients, aged 35-65 years (mean age 54.1 AE 7.1), with a follow-up period of 10 years. Patients underwent vascular evaluation including P-CDU, colour doppler ultrasound of the carotid and lower limbs arteries. At baseline data for glucose metabolism, lipid profile, hypertension and hormonal status were collected. During the follow-up period, the occurrence of MACE was evaluated. Results: We found a strong association between cavernous arteries morphological alterations and CVD with a threefold increased risk of future MACE in comparison to patients with healthy cavernous arteries (RR 3.2, 95% CI 1. 17-8.78). This association remained statistically significant after adjustment for CV risk factors (age, glycaemia, total cholesterol, hypertension and smoke). Conclusions: Morphological alterations of cavernous arteries are independently associated with an increased risk of future MACE. These data contribute to the formulation of the hypothesis that cavernous artery pathology at P-CDU is related to MACE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

et al. 2018

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“…ED and its severity have been associated with an increase in the expression of markers such as C-reactive protein (CRP), IL-6, IL-10, IL-1B, intercellular adhesion molecule 1 and tumor necrosis factor alpha (TNF-α). Likewise, endothelial and prothrombotic factors such as Von Willebrand factor, tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1) and ibrinogen have been found at high levels in patients with ED [14][15][16]. Therefore, chronic in lammation may represent an important relationship between ED and cardiovascular disease [5].…”

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confidence: 99%

“…It has also been shown to be associated with smoking, both active and passive, since smoking induces endothelial dysfunction, in lammation, oxidative stress with generation of reactive oxygen species and decreased NO production; therefore suspending tobacco is one of the strategies in the multimodal therapy of ED. Other related factors have been hypertension, obesity, metabolic syndrome and DM2 [2,16].…”

mentioning

confidence: 99%

“…ED can predict the morbidity and mortality due to cardiovascular disease in patients with DM2, since these may present a silent disease, therefore the early identi ication of risk factors can be bene icial in terms of prevention. It is estimated that approximately 35-75% of men with DM2 have ED and that they tend to develop the disease 5-10 years earlier than those without DM2 [2,16].…”

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confidence: 99%

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Erectile Dysfunction and Coronary Artery Disease: Two manifestations, one same underlying mechanism

Cardona-Vélez¹,

Ceballos-Naranjo²

2018

Insights Biol Med

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Erectile dysfunction (ED) is a common disorder whose prevalence increases with age. Over time a strong correlation between erectile dysfunction and cardiovascular disease has been established as the result of the same pathophysiological process: endothelial dysfunction and atherosclerosis. Because small vessels of the penis can be affected by atherosclerotic plaque earlier than coronary arteries, carotids or femoral arteries, men often have symptoms of ED long before the signs of cardiovascular disease appear. For this reason, ED can act as a marker of early atherosclerosis that predicts the onset of cardiovascular disease at a later time. Erectile dysfunction (ED) is de ined as the inability to achieve and/or sustain an adequate erection to complete a sexual relationship; it may be accompanied by decreased libido and abnormal ejaculation [1]. It is a common disorder and its prevalence increases with age, being more frequent in elderly men. It affects 5-10% of those over 40's and 40-70% of those over 70's; it is estimated that there are about 150 million affected men worldwide and that by 2025 it will affect more than 300 million [2-5]. ShortOver time many studies have shown a correlation between ED and cardiovascular risk; both entities share many risk factors such as age, type 2 diabetes mellitus (DM2), hypertension (HT), dyslipidemia, smoking, obesity and sedentary lifestyle [6][7][8][9]. Therefore, it is believed that ED and coronary artery disease (CAD) are clinical manifestations of the same pathophysiological process, product of a severe endothelial dysfunction [10][11][12]. In the study conducted by Demirkol S et al., it was found that erectile function was signi icantly decreased in patients who presented both microvascular angina (syndrome X) and CAD, thus they conclude that ED and syndrome X are manifestations of a common vascular phenomenon that includes endothelial dysfunction as the mechanism underlying both conditions [4].The pathophysiology of microvascular angina has not been clearly elucidated, although several abnormalities have been proposed including: alteration in coronary low reserve, insulin resistance, abnormal autonomic control and microvascular spasm; all these, also associated with endothelial dysfunction, which is another traditional risk factor for cardiovascular disease and occurs before the development of apparent functional or structural systemic vascular disease [6,12]. It is characterized by a decrease in the bioavailability of endogenous nitric oxide (NO) and increase in plasma levels of endothelin-1, promoting in turn an increase in oxidative stress and vasoconstrictor mediators such as angiotensin II, causing generalized damage in the vascular endothelium, being the arteries of the penis more susceptible due to their size and therefore affected earlier 4 . In this way, both the loss in bioavailability of NO and endothelial dysfunction are phenomena that occur in the earliest stages of atherosclerosis and are also associated with traditional risk factors of cardiovasc...

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Phosphodiesterase‐5 Inhibitory Activity of Canthin‐6‐One Alkaloids and the Roots of Eurycoma longifolia and Eurycoma harmandiana

Choonong

Chaingam

Chantakul

et al. 2022

Chemistry & Biodiversity

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Eurycoma longifolia (EL) and Eurycoma harmandiana (EH) are natural medicinal plants belonging to the Simaroubaceae family, and are well‐known for their ability to enhance male sexual performance. The present study investigated the phosphodiesterase‐5 (PDE‐5) inhibitory activity of intact roots of EL and EH. Additionally, canthin‐6‐one alkaloids, β‐carboline alkaloids, and quassinoids were also screened for PDE‐5 inhibitory activity. We developed in vitro root and callus cultures of EL and EH to determine their PDE‐5 inhibitory activity. Our results indicated that canthin‐6‐one alkaloids, which include canthin‐6‐one‐9‐O‐β‐D‐glucopyranoside, 9‐methoxycanthin‐6‐one, canthin‐6‐one, and 9‐hydroxycanthin‐6‐one, exhibited PDE‐5 enzymatic inhibitory activity, with IC50 values of 2.86±0.23, 3.30±1.03, 4.31±0.52, and 4.66±1.13 μM, respectively. The ethanolic extract of the intact roots of EL and EH, and the in vitro root culture of EH had large amounts of canthin‐6‐one alkaloids (1.50±0.04, 2.12±0.03, and 3.48±0.08 mg/g dry weight, respectively), and showed potent PDE‐5 inhibition. Our findings indicate that in vitro root cultures of EH may be used to replace intact plants, and canthin‐6‐one‐9‐O‐β‐D‐glucopyranoside should be further investigated for development as a health supplement.

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The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

Cited by 50 publications

References 62 publications

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

Erectile Dysfunction and Coronary Artery Disease: Two manifestations, one same underlying mechanism

Phosphodiesterase‐5 Inhibitory Activity of Canthin‐6‐One Alkaloids and the Roots of Eurycoma longifolia and Eurycoma harmandiana

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