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Erectile dysfunction—a cardiovascular disease?

Erectile dysfunction (ED) is a common condition and studies predict it to be an increasing problem in the future. It is a deeply distressing condition, which can severely diminish quality of life. Although there are many causes, there is increasing evidence to suggest that it is predominantly a vascular disease and may even be a marker for occult cardiovascular disease. Increasing awareness of this association would encourage men and health care professionals to address the issue of ED more freely, allow screening for cardiovascular disease and thereby reduce cardiovascular morbidity and even mortality. Many men with established cardiovascular disease have ED. Specific guidelines for the management of ED in these patients have been produced by two expert panels, and these can also be applied to men without known cardiovascular disease. Cardiovascular risk stratification is an important initial step in managing ED patients. The management of ED in cardiac patients can be safe and effective providing they are properly assessed.