Erectile Dysfunction and the Heart
I. Mechanism of Erectile Dysfunction
II. Causes of Erectile Dysfunction
III. Management
GLOSSARY
dyslipidemia the same as hyperlipidemia, elevated blood choles¬terol, LDL cholesterol, triglycerides, or low HDL cholesterol.
of the intima that comes in a silky smooth layer of epi-
endothelium the innermost part contact with circulating blood, thelial cells.
heart failure failure of the heart to pump sufficient blood from the chambers into the aorta; inadequate supply of blood reaches organs and tissues.
ischemia temporary lack of blood and oxygen to an area of cells, for example, the heart muscle, usually due to severe obstruc¬tion of the artery supplying blood to this area of cells.
myocardial infarction death of an area of heart muscle due to blockage of the coronary artery by blood clot and atheroma; medical term for a heart attack or coronary thrombosis.
ERECTILE DYSFUNCTION (ED) IS OBSERVED OFTEN in men with cardiovascular disease. In a Boston survey of 1790 free living men age 40–70, 50% reported some degree of ED — 10% severe and 25% moderate. ED occurs in men worldwide and has several causes, but cardiovascular disease and diabetes play a major role in many individuals. Some investigators have suggested that ED may serve as a predictor for cardiovascular disease, because in both conditions endothelial dysfunction is deranged. Endothelial dysfunction is a well-defined entity and is a major player in the pathogenesis of atherosclerosis, its complications, and symptomatology. Endothelial dys¬function shares many common risk factors with both atherosclerotic vascular disease and ED.
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- I. MECHANISM OF ERECTILE DYSFUNCTION
A. Physiology of Penile Erection - II. CAUSES OF ERECTILE DYSFUNCTION
Psychogenic factors including depression are common causes of ED. About 25–75% of patients with depression experience some degree of ED. Cigarette smoking and alcohol have a negative impact on penile blood flow as well as on the nerve supply. Cigarette smoking appears to cause a constriction of small penile arteries. - III. MANAGEMENT
A. Phosphodiesterase Inhibitors - BIBLIOGRAPHY
DeBusk, R., Dory, Y., Goldstein, I. et al. Management of sexual dysfunction in patients with cardiovascular disease and recommen¬dations of the Princeton consensus panel. Am. J. Cardiol., 86(2): 175–81, 2000.