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Cardiovascular Disease Prevention in Men with Vascular Erectile Dysfunction - The View of the Preventive Cardiologist.


AUTHORS

Shah NP , Cainzos-Achirica M , Feldman DI , Blumenthal RS , Nasir K , Miner MM , Billups KL , Blaha MJ , . The American journal of medicine. 2015 10 15; ().

ABSTRACT

Vascular erectile dysfunction is a powerful marker of increased cardiovascular risk. Current guidelines, however, lack specific recommendations on the role that the evaluation of vascular erectile dysfunction should play in cardiovascular risk assessment, as well on the risk stratification strategy that men with vascular erectile dysfunction should undergo. In the last three years, erectile dysfunction experts have made a call for more specific guidance, and have proposed the selective use of several prognostic tests for further cardiovascular risk assessment in these patients. Among them, stress testing has been prioritized, while other tests are considered second-line tools. In this review, we provide additional perspective from the viewpoint of the preventive cardiologist. We discuss the limitations of current risk scores, as well as the potential interplay between erectile dysfunction assessment and the use of personalized prognostic tools such as the coronary artery calcium score, in the cardiovascular risk stratification and management of men with vascular erectile dysfunction. Finally, we present an algorithm for primary care physicians, urologists, and cardiologists to aid clinical decision-making.


Vascular erectile dysfunction is a powerful marker of increased cardiovascular risk. Current guidelines, however, lack specific recommendations on the role that the evaluation of vascular erectile dysfunction should play in cardiovascular risk assessment, as well on the risk stratification strategy that men with vascular erectile dysfunction should undergo. In the last three years, erectile dysfunction experts have made a call for more specific guidance, and have proposed the selective use of several prognostic tests for further cardiovascular risk assessment in these patients. Among them, stress testing has been prioritized, while other tests are considered second-line tools. In this review, we provide additional perspective from the viewpoint of the preventive cardiologist. We discuss the limitations of current risk scores, as well as the potential interplay between erectile dysfunction assessment and the use of personalized prognostic tools such as the coronary artery calcium score, in the cardiovascular risk stratification and management of men with vascular erectile dysfunction. Finally, we present an algorithm for primary care physicians, urologists, and cardiologists to aid clinical decision-making.


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