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Erectile Dysfunction: an Early Sign of Cardiovascular Disease

  • Novel + Emerging Risk Factors (K Nasir, Section Editor)
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Abstract

Identification of vasculogenic erectile dysfunction (ED) should be used to focus preventive efforts on reducing the risk of future cardiovascular events. For younger men 40 to 60 years old believed to have predominantly vasculogenic ED, we recommend an algorithm for further assessment of cardiovascular disease modified from the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) risk assessment guidelines. We propose that all men with confirmed vasculogenic ED and no overt cardiovascular disease symptoms undergo noninvasive evaluation using a coronary artery calcium (CAC) score. For men with low to intermediate risk (atherosclerotic cardiovascular disease (ASCVD) risk score 0–10 %), CAC score can be used to guide decisions regarding initiation of therapies, and in patients with high CVD risk, after referral to a cardiologist for a full evaluation, CAC can be used to guide intensity of therapies. We recommend that men with ED be evaluated using this modified risk assessment to incorporate factors otherwise excluded from the ACC/AHA calculator.

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Authors and Affiliations

  1. The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, 601 N. Caroline Street, JHOC Building; Room 4068, Baltimore, MD, 21287, USA

    Kevin L. Billups

  2. Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Blalock 501, Johns Hopkins Hospital, Carnegie 565A, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Robert V. Same, Michael J. Blaha, David I. Feldman & Kevin L. Billups

  3. Departments of Family Medicine and Urology, Miriam Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Martin M. Miner

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  1. Robert V. Same
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  2. Martin M. Miner
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  3. Michael J. Blaha
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  4. David I. Feldman
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  5. Kevin L. Billups
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Correspondence to Kevin L. Billups.

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Conflict of Interest

Kevin L. Billups is a consultant to Endo Pharmaceuticals, Chadds Ford, PA, AbbVie Inc., North Chicago, IL, and Clarus Therapeutics Inc., Northbrook, IL.

Michael J. Blaha is a consultant to Pfizer and Luitpold Pharmaceuticals.

Martin M. Miner is a consultant to AbbVie Laboratories, North Chicago, IL, Liposine, and TestoRx.

David I. Feldman and Robert V. Same do not have any conflicts of interest to report.

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Same, R.V., Miner, M.M., Blaha, M.J. et al. Erectile Dysfunction: an Early Sign of Cardiovascular Disease. Curr Cardiovasc Risk Rep 9, 49 (2015). https://doi.org/10.1007/s12170-015-0477-y

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