Skip to main content
SpringerLink
Log in

Erektile Dysfunktion: Indikator für Endorganschädigung beim kardiovaskulären Patienten

Erectile Dysfunction: Indicator of End-Organ Damage in Cardiovascular Patients

  • ÜBERSICHT
  • Published:
Medizinische Klinik Aims and scope Submit manuscript

Zusammenfassung

Die Prävalenz der erektilen Dysfunktion (ED) beträgt in der Allgemeinbevölkerung ca. 20–30% und steigt bei kardiovaskulären Risikopatienten auf 50–70%. Ursächlich ist die Assoziation der ED mit den bekannten kardiovaskulären Risikofaktoren im Hinblick auf die Physiologie der Erektion, bei der eine intakte Endothelfunktion der penilen Gefäße sowie des Corpus cavernosum eine zentrale Rolle spielt. Darüber hinaus korreliert der Schweregrad der ED mit dem kardiovaskulären Risiko der Patienten und stellt ein frühes Symptom einer generalisierten Atherosklerose dar. Entsprechend können bei Patienten mit Störung der Erektionsfähigkeit kardiovaskuläre Risikofaktoren und Erkrankungen frühzeitig diagnostiziert und risikoadjustiert therapiert werden. Zudem zeigen mehrere Studien, dass die erektile Funktion ein Prädiktor für kardiovaskuläre Ereignisse wie Myokardinfarkt und Schlaganfall ist.

Abstract

Prevalence of erectile dysfunction (ED) amounts to 20–30% in a general population and increases to 50–70% in cardiovascular high-risk patients. Association of ED with known cardiovascular risk factors is causal with endothelial function of penile vessels and corpora cavernosa playing a crucial role in physiology of erection. Moreover, severity of ED correlates with cardiovascular risk of patients and represents an early symptom of generalized atherosclerosis. Hence, cardiovascular risk factors and diseases are sooner diagnosed in patients with ED with the opportunity of risk-adjusted prevention. Furthermore, different trials suggest erectile function as a strong predictor of cardiovascular events like myocardial infarction or stroke.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993;270:83–90.

    Article  Google Scholar 

  2. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61.

    PubMed  CAS  Google Scholar 

  3. Braun M, Wassmer G, Klotz T, et al. Epidemiology of erectile dysfunction: results of the “Cologne Male Survey”. Int J Impot Res 2000;12:305–11.

    Article  PubMed  CAS  Google Scholar 

  4. Böhm M, Baumhäkel M, Probstfield JL, et al. Sexual function, satisfaction, and association of erectile dysfunction with cardiovascular disease and risk factors in cardiovascular high-risk patients: substudy of the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmis artan Randomized AssessmeNt Study in ACE-iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND). Am Heart J 2007;154:94–101.

    Article  PubMed  Google Scholar 

  5. Roth A, Kalter-Leibovici O, Kerbis Y, et al. Prevalence and risk factors for erectile dysfunction in men with diabetes, hypertension, or both diseases: a community survey among 1,412 Israeli men. Clin Cardiol 2003;26:25–30.

    Article  PubMed  Google Scholar 

  6. Grimm RH Jr, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension 1997;29:8–14.

    PubMed  CAS  Google Scholar 

  7. Feldman HA, Johannes CB, Derby CA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts Male Aging Study. Prev Med 2000;30:328–38.

    Article  PubMed  CAS  Google Scholar 

  8. Juenemann KP, Lue TF, Luo JA, et al. The effect of cigarette smoking on penile erection. J Urol 1987;138:438–41.

    PubMed  CAS  Google Scholar 

  9. Saltzman EA, Guay AT, Jacobson J. Improvement in erectile function in men with organic erectile dysfunction by correction of elevated cholesterol levels: a clinical observation. J Urol 2004;172:255–8.

    Article  PubMed  Google Scholar 

  10. Azadzoi KM, Saenz de Tejada I. Hypercholesterolemia impairs endothelium-dependent relaxation of rabbit corpus cavernosum smooth muscle. J Urol 1991;146:238–40.

    PubMed  CAS  Google Scholar 

  11. Baumhäkel M, Schlimmer N, Buyukafsar K, et al. Nebivolol, but not metoprolol improves endothelial function of the corpus cavernosum in ApoEknockout-mice. J Pharmacol Exp Ther 2008;325:818–23.

    Article  PubMed  Google Scholar 

  12. Bocchio M, Desideri G, Scarpelli P, et al. Endothelial cell activation in men with erectile dysfunction without cardiovascular risk factors and overt vascular damage. J Urol 2004;171:1601–4.

    Article  PubMed  Google Scholar 

  13. Billups KL, Kaiser DR, Kelly AS, et al. Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res 2003;15:231–6.

    Article  PubMed  CAS  Google Scholar 

  14. Flesch M, Knipp S, Kessler G, et al. ARTA: AT1-receptor blocker therapy in patients undergoing coronary artery bypass grafting. Clin Res Cardiol 2009;98:33–43.

    Article  PubMed  CAS  Google Scholar 

  15. Werner C, Baumhäkel M, Teo KK, et al. RAS blockade with ARB and ACE inhibitors: current perspective on rationale and patient selection. Clin Res Cardiol 2008;97:418–31.

    Article  PubMed  CAS  Google Scholar 

  16. Baumhäkel M, Custodis F, Schlimmer N, et al. Improvement of endothelial function of the corpus cavernosum in apolipoprotein E knockout mice treated with irbesartan. J Pharmacol Exp Ther 2008;327:692–8.

    Article  PubMed  Google Scholar 

  17. Becker AJ, Uckert S, Stief CG, et al. Plasma levels of angiotensin II during different penile conditions in the cavernous and systemic blood of healthy men and patients with erectile dysfunction. Urology 2001;58:805–10.

    Article  PubMed  CAS  Google Scholar 

  18. Kifor I, Williams GH, Vickers MA, et al. Tissue angiotensin II as a modulator of erectile function. I. Angiotensin peptide content, secretion and effects in the corpus cavernosum. J Urol 1997;157:1920–5.

    Article  PubMed  CAS  Google Scholar 

  19. Werner N, Kosiol S, Schiegl T, et al. Circulating endothelial progenitor cells and cardiovascular outcomes. N Engl J Med 2005;353:999–1007.

    Article  PubMed  CAS  Google Scholar 

  20. Werner N, Junk S, Laufs U, et al. Intravenous transfusion of endothelial progenitor cells reduces neointima formation after vascular injury. Circ Res 2003;93:e17–24.

    Article  PubMed  CAS  Google Scholar 

  21. Baumhäkel M, Werner N, Böhm M, et al. Circulating endothelial progenitor cells correlate with erectile function in patients with coronary heart disease. Eur Heart J 2006;27:2184–8.

    Article  PubMed  Google Scholar 

  22. Walczak MK, Lokhandwala N, Hodge MB, et al. Prevalence of cardiovascular risk factors in erectile dysfunction. J Gend Specif Med 2002;5:19–24.

    PubMed  Google Scholar 

  23. Kaiser DR, Billups K, Mason C, et al. Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004;43:179–84.

    Article  PubMed  Google Scholar 

  24. Yavuzgil O, Altay B, Zoghi M, et al. Endothelial function in patients with vasculogenic erectile dysfunction. Int J Cardiol 2005;103:19–26.

    Article  PubMed  Google Scholar 

  25. Greenstein A, Chen J, Miller H, et al. Does severity of ischemic coronary disease correlate with erectile function? Int J Impot Res 1997;9:123–6.

    Article  PubMed  CAS  Google Scholar 

  26. Yaman O, Gulpinar O, Hasan T, et al. Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 2008;40:117–23.

    Article  PubMed  Google Scholar 

  27. Montorsi P, Ravagnani PM, Galli S, et al. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol 2005;96:19M–23M.

    Article  PubMed  Google Scholar 

  28. Billups KL, Bank AJ, Padma-Nathan H, et al. Erectile dysfunction is a marker for cardiovascular disease: results of the Minority Health Institute Expert Advisory Panel. J Sex Med 2005;2:40–50.

    Article  PubMed  Google Scholar 

  29. Vlachopoulos C, Rokkas K, Ioakeimidis N, et al. Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005;48:996–1002.

    Article  PubMed  Google Scholar 

  30. Fornengo P, Bosio A, Epifani G, et al. Prevalence of silent myocardial ischaemia in new-onset middle-aged type 2 diabetic patients without other cardiovascular risk factors. Diabet Med 2006;23:775–9.

    Article  PubMed  CAS  Google Scholar 

  31. Gazzaruso C, Giordanetti S, De Amici E, et al. Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients. Circulation 2004;110:22–6.

    Article  PubMed  Google Scholar 

  32. Thompson IM, Tangen CM, Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294:2996–3002.

    Article  PubMed  CAS  Google Scholar 

  33. Montorsi P, Ravagnani P, Galli S, et al. Erectile dysfunction predicts extent of coronary artery disease in acute coronary syndromes. Circulation 2005;111; Suppl II:690.abstract 3232.

    Google Scholar 

  34. Baumhäkel M, Böhm M. Erectile dysfunction correlates with left ventricular function and precedes cardiovascular events in cardiovascular high-risk patients. Int J Clin Pract 2007;61:361–6.

    Article  PubMed  Google Scholar 

  35. Montorsi P, Ravagnani P, Galli S, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006;27:2632–9.

    Article  PubMed  Google Scholar 

  36. Bakris G, Böhm M, Dagenais G, et al. Cardiovascular protection for all individuals at high risk: evidence-based best practice. Clin Res Cardiol 2008;97:713–25.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany

    Michael Böhm

  2. Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Germany

    Magnus Baumhäkel

Authors
  1. Magnus Baumhäkel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nils Schlimmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mario T. Kratz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Böhm
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Magnus Baumhäkel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baumhäkel, M., Schlimmer, N., Kratz, M.T. et al. Erektile Dysfunktion: Indikator für Endorganschädigung beim kardiovaskulären Patienten. Med Klin 104, 309–313 (2009). https://doi.org/10.1007/s00063-009-1051-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00063-009-1051-5

Schlüsselwörter:

Key Words:

Search

Navigation