Zain Gowani1, S M Iftekhar Uddin2, Mohammadhassan Mirbolouk2, Dawar Ayyaz2, Kevin L Billups3, Martin Miner4, David I Feldman2,5, Michael J Blaha2. 1. Johns Hopkins Bayview Medical Center, Baltimore, Maryland. 2. Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland. 3. Department of Surgery, Meharry Medical College, Nashville, Tennessee. 4. Department of Family Medicine, Alpert Medical School of Brown University, Providence, Rhode Island. 5. The University of Miami Miller School of Medicine, Miami, Florida.
Abstract
PURPOSE OF REVIEW: We review the recent literature on the hypothesized temporal relationship between subclinical cardiovascular disease (CVD), vascular erectile dysfunction (ED), and clinical CVD. In addition, we combine emerging research with expert consensus guidelines such as The Princeton Consensus III to provide a preventive cardiologist's perspective toward an ideal approach to evaluating and managing CVD and ED risk in patients. RECENT FINDINGS: Development of ED was found to occur during the progression from subclinical CVD to clinical CVD. A strong association was observed between subclinical CVD as assessed by coronary artery calcium (CAC) and carotid plaque and subsequent ED, providing evidence for the role of subclinical CVD in predicting ED. ED is also identified as a substantial independent risk factor for overt clinical CVD, and ED symptoms may precede CVD symptoms by 2-3 years. SUMMARY: Given the body of evidence on the relationship between subclinical CVD, ED, and clinical CVD we recommend that all men with vascular ED should undergo cardiovascular risk assessment. We further recommend using CAC scores for advanced risk assessment in patients at low-intermediate to intermediate risk (5-20% CVD risk), with risk driving subsequent lifestyle and pharmacologic treatment decisions.
PURPOSE OF REVIEW: We review the recent literature on the hypothesized temporal relationship between subclinical cardiovascular disease (CVD), vascular erectile dysfunction (ED), and clinical CVD. In addition, we combine emerging research with expert consensus guidelines such as The Princeton Consensus III to provide a preventive cardiologist's perspective toward an ideal approach to evaluating and managing CVD and ED risk in patients. RECENT FINDINGS: Development of ED was found to occur during the progression from subclinical CVD to clinical CVD. A strong association was observed between subclinical CVD as assessed by coronary artery calcium (CAC) and carotid plaque and subsequent ED, providing evidence for the role of subclinical CVD in predicting ED. ED is also identified as a substantial independent risk factor for overt clinical CVD, and ED symptoms may precede CVD symptoms by 2-3 years. SUMMARY: Given the body of evidence on the relationship between subclinical CVD, ED, and clinical CVD we recommend that all men with vascular ED should undergo cardiovascular risk assessment. We further recommend using CAC scores for advanced risk assessment in patients at low-intermediate to intermediate risk (5-20% CVD risk), with risk driving subsequent lifestyle and pharmacologic treatment decisions.
Authors: Haitham M Ahmed; Mouaz H Al-Mallah; John W McEvoy; Khurram Nasir; Roger S Blumenthal; Steven R Jones; Clinton A Brawner; Steven J Keteyian; Michael J Blaha Journal: Mayo Clin Proc Date: 2015-03 Impact factor: 7.616
Authors: James M Hotaling; Thomas J Walsh; Liam Connor Macleod; Susan Heckbert; Gaia Pocobelli; Hunter Wessells; Emily White Journal: J Sex Med Date: 2012-07-03 Impact factor: 3.802
Authors: Robert Detrano; Alan D Guerci; J Jeffrey Carr; Diane E Bild; Gregory Burke; Aaron R Folsom; Kiang Liu; Steven Shea; Moyses Szklo; David A Bluemke; Daniel H O'Leary; Russell Tracy; Karol Watson; Nathan D Wong; Richard A Kronmal Journal: N Engl J Med Date: 2008-03-27 Impact factor: 91.245
Authors: John Jeffrey Carr; David R Jacobs; James G Terry; Christina M Shay; Stephen Sidney; Kiang Liu; Pamela J Schreiner; Cora E Lewis; James M Shikany; Jared P Reis; David C Goff Journal: JAMA Cardiol Date: 2017-04-01 Impact factor: 14.676
Authors: Yoshihiro Tanaka; Joshua D Bundy; Norrina B Allen; S M Iftekhar Uddin; David I Feldman; Erin D Michos; Susan R Heckbert; Philip Greenland Journal: Am J Med Date: 2019-11-16 Impact factor: 4.965
Authors: Narendra N Khanna; Mahesh Maindarkar; Ajit Saxena; Puneet Ahluwalia; Sudip Paul; Saurabh K Srivastava; Elisa Cuadrado-Godia; Aditya Sharma; Tomaz Omerzu; Luca Saba; Sophie Mavrogeni; Monika Turk; John R Laird; George D Kitas; Mostafa Fatemi; Al Baha Barqawi; Martin Miner; Inder M Singh; Amer Johri; Mannudeep M Kalra; Vikas Agarwal; Kosmas I Paraskevas; Jagjit S Teji; Mostafa M Fouda; Gyan Pareek; Jasjit S Suri Journal: Diagnostics (Basel) Date: 2022-05-17
Authors: Shakeel Ahmed Memon; Muhammad Adil; Fahad Raja Khan; Safi Ullah; Samra Rehmat; Nooh Zad Gul Journal: Int J Cardiol Heart Vasc Date: 2022-04-18