Erectile dysfunction (ED) is associated with modifiable risk factors. Obesity, physical inactivity, and the metabolic syndrome increase the incidence of ED and markers of low-grade inflammation, which in turn are associated with endothelial dysfunction. Intensive intervention with lifestyle advice focusing on a healthy diet, weight loss, and increased physical activity benefits men with ED and in addition reduces the markers of inflammation and improves endothelial function. Though phosphodiesterase type 5 inhibitors are highly effective in treating ED, lifestyle advice and aggressive risk reduction remain fundamental to the overall vascular good health of the individual.
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References and Recommended Reading
Solomon H, Man JW, Jackson G: Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 2003, 89:251–253.
Montorsi P, Ravagnani PM, Galli S, et al.: Association between erectile dysfunction and coronary artery disease: matching the right target with the right test in the right patient. Eur Urol 2006, 50:721–731.
Jackson G: Erectile dysfunction: a marker of silent coronary artery disease. Eur Heart J 2006, 27:2613–2614.
Vlachopoulos C, Aznaouridis K, Ioakeimidis N, et al.: Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J 2006, 27:2640–2648.
Jackson G, Rosen RC, Kloner RA, Kostis JB: The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 2006, 3:28–36.
Bacon CG, Mittleman MA, Kawachi I, et al.: A prospective study of risk factors for erectile dysfunction. J Urol 2006, 176:217–221.
Blanker MH, Bohnen AM, Groeneveld FP, et al.: Correlates for erectile and ejaculatory dysfunction in older Dutch men: a community-based study. J Am Geriatr Soc 2001, 49:436–442.
Holden CA, McLachlan RI, Pitts M, et al.: Men in Australia Telephone Survey (MATeS) I: a national survey of the reproductive health and concerns of middle aged and older Australian men. Lancet 2005, 366:218–224.
Kapelman PG: Obesity as a medical problem. Nature 2000, 404:635–643.
Yudkin JS, Stehouwer CD, Emeis JJ, et al.: C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999, 19:972–978.
Esposito K, Giugliano F, Di Palo C, et al.: Effect of lifestyle changes on erectile dysfunction in men: a randomised controlled trial. JAMA 2004, 291:2978–2984.
Laurmann EO, Nicolosi A, Glasser DB, et al.: Sexual problems among women and men aged 40–80 years: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviour. Int J Impot Res 2005, 17:39–57.
Johannes CB, Araujo AB, Fieldman HA, et al.: Incidence of erectile dysfunction in men aged 40 to 69 years old: longitudinal results from the Massachusetts Male Aging Study. J Urol 2000, 163:460–463.
Juenemann KP, Lue TF, Luo JA, et al.: The effect of cigarette smoking on penile erection. J Urol 1987, 138:438–441.
Glina S, Reichet AC, Leao PP, et al.: Impact of cigarette smoking on papaverine-induced erection. J Urol 1988, 140:523–524.
Jackson G: The metabolic syndrome and erectile dysfunction: multiple vascular risk factors and hypogonadism. Eur Urol 2006, 50:426–427.
Esposito K, Giugliano F, Margedi E et al.: High proportions of erectile dysfunction in men with the metabolic syndrome. Diabetes Care 2005, 28:1201–1203.
Kupelian V, Shabsigh R, Araujo AA, et al.: Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006, 176:222–226.
Corona G, Mannucci E, Schulmann C, et al.: Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol 2006, 50:595–602.
Makhsida N, Shah J, Yan G, et al.: Hypogonadism and metabolic syndrome: implications for testosterone therapy. J Urol 2005, 174:827–834.
Esposito K, Ciobola M, Giugliano F, et al.: Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int J Impot Res 2006, 18:405–410.
Bruckert E, Giral P, Heshmati HM, Turpin G: Men treated with hypolipidaemic drugs complain more frequently of erectile dysfunction. J Clin Pharm Ther 1996, 21:89–94.
Solomon H, Samarasingh YP, Feher MD, et al.: Erectile dysfunction and statin treatment in high cardiovascular risk patients. Int J Clin Pract 2006, 60:141–148.
Hermann HC, Levine LA, Macalusa J, et al.: Can atorvastatin improve the response to sildenafil in men with erectile dysfunction not initially responsive to sildenafil? Hypothesis and pilot trial results. J Sex Med 2006, 3:303–308.
Solomon H, Wierzbicki AS, Lumb PJ, et al.: Cardiovascular risk factors determine erectile and arterial function response to sildenafil. Am J Hypertens 2006, 19:915–919.
Fogari R, Zoppi A, Polett L, et al.: Sexual activity in hypertensive men treated with valsartan or carvedilol: a crossover study. Am J Hypertens 2001, 14:27–31.
Jackson G: Erectile dysfunction and hypertension. Int J Clin Pract 2002, 56:491–492.
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Jackson, G. The importance of risk factor reduction in erectile dysfunction. Curr sex health rep 4, 114–117 (2007). https://doi.org/10.1007/s11930-007-0012-3
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