Erectile dysfunction as a marker and predictor of cardiovascular disease

2018 ◽  
Author(s):  
Charalambos Vlachopoulos ◽  
Nikolaos Ioakeimidis
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Endothelial Dysfunction ◽  
Coronary Circulation ◽  
Atherosclerotic Burden ◽  
Penile Artery ◽  
Coronary Events ◽  
Artery Disease

Erectile dysfunction (ED) is defined as the inability to obtain or maintain a penile erection to support satisfactory sexual performance. It is considered an early manifestation of generalized vascular disease and recognized as a marker of increased cardiovascular risk both acutely and chronically by predicting all-cause mortality, cardiovascular mortality, coronary events, stroke, and peripheral artery disease in men with and without known coronary artery disease. The link between ED and cardiovascular disease might reside in the interaction between androgen level, chronic inflammation, and cardiovascular risk factors that determine endothelial dysfunction and atherosclerosis both in the penile and coronary circulation. Because penile artery size is smaller compared with coronary arteries, the same degree of endothelial dysfunction and atherosclerotic burden causes a more significant reduction of blood flow in erectile tissues compared with that in coronary circulation. From a clinical standpoint, because ED may precede cardiovascular disease, it can be used as an early marker to identify men at higher risk of cardiovascular events. The average 3-year time period between the onset of ED symptoms and a cardiovascular event offers the opportunity for detailed cardiological assessment and intensive treatment of risk factors.

Erectile dysfunction as a marker and predictor of cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 1016-1019
Author(s):  
Charalambos Vlachopoulos ◽  
Nikolaos Ioakeimidis
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Endothelial Dysfunction ◽  
Coronary Circulation ◽  
Atherosclerotic Burden ◽  
Penile Artery ◽  
Coronary Events ◽  
Artery Disease

Erectile dysfunction (ED) is defined as the inability to obtain or maintain a penile erection to support satisfactory sexual performance. It is considered an early manifestation of generalized vascular disease and recognized as a marker of increased cardiovascular risk both acutely and chronically by predicting all-cause mortality, cardiovascular mortality, coronary events, stroke, and peripheral artery disease in men with and without known coronary artery disease. The link between ED and cardiovascular disease might reside in the interaction between androgen level, chronic inflammation, and cardiovascular risk factors that determine endothelial dysfunction and atherosclerosis both in the penile and coronary circulation. Because penile artery size is smaller compared with coronary arteries, the same degree of endothelial dysfunction and atherosclerotic burden causes a more significant reduction of blood flow in erectile tissues compared with that in coronary circulation. From a clinical standpoint, because ED may precede cardiovascular disease, it can be used as an early marker to identify men at higher risk of cardiovascular events. The average 3-year time period between the onset of ED symptoms and a cardiovascular event offers the opportunity for detailed cardiological assessment and intensive treatment of risk factors.

scholarly journals Role of Traditional Cardiovascular Risk Factors for the Occurrence of Erectile Dysfunction in Patients with Coronary Artery Disease

2017 ◽  
pp. 137-44
Author(s):  
Heri Hernawan ◽  
Irsad Andi Arso ◽  
Erika Maharani
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Traditional Cardiovascular Risk Factor ◽  
Artery Disease ◽  
Stable Cad

Background: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient to permit satisfactory sexual intercourse. Erectile dysfunction affects more than 150 million men worldwide and impairs psychological well-being and personal relationships, hence quality of life. Recent studies have shown that ED is present in 42% to 76% of men with coronary artery disease (CAD). Epidemiological study showed clearly role of traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and smoking in CAD. Erectile dysfunction and vascular diseases share a similar risk factors and pathogenic involvement of nitric oxide (NO)-pathway leading to impairment of endothelium-dependent vasodilatation (early phase) and structural vascular abnormalities (late phase). This study was conducted to determine whether the stable CAD patients who have traditional cardiovascular risk factors has a higher risk for ED compared with stable CAD patients without traditional cardiovascular risk factors.Methods: We performed an age matched-paired case control study. Men with CAD documented by angiography were evaluated for ED. Erectile function was assessed by a 5-item version of the International Index of Erectile Function (IIEF-5). Traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and cigarette smoking were assesed. Depression and anxiety were screened using Indonesian version of Hospital Anxiety and Depression Scale (HADS). Basic demographic and other variables were also collected.Results: This study evaluated 127 men, 96.8% of them had traditional cardiovascular risk factors, 25.2% had diabetes mellitus, 77.2% had dyslipidemia, 55.9% had hypertension and 64.6% were smoker. Traditional cardiovascular risk factors was strongly associated with ED (OR=10.67 [1.25-232.83]). ED was independently associated with diabetes mellitus (OR=4.17 [1.14-15.24]), hypertension (OR=2.64 [1.07-6.49]) and cigarette smoking (OR=2.26 [1.01-5.75]).Conclusion: CAD patients with traditional cardiovascular risk factor had more risk for developing ED than those with no traditional cardiovascular risk factor.

Epidemiology and risk factors

ESC CardioMed ◽  
2018 ◽  
pp. 2692-2694
Author(s):  
Marie-Louise Bartelink
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Carotid Artery Disease ◽  
Vascular Territory ◽  
Total Risk ◽  
Coronary Events ◽  
Artery Disease ◽  
Strength Of Association ◽  
The Brain

Overall the risk of different localizations of PADs increases sharply with age and with exposure to major cardiovascular risk factors: smoking, hypertension, dyslipidaemia and diabetes. Other risk factors are still under investigation. The strength of association between each risk factor and each vascular territory is variable, but all the major risk factors should be screened and considered. When a vascular territory is affected by atherosclerosis, not only is the corresponding organ endangered (e.g. the brain for carotid artery disease) but also the total risk of any cardiovascular event is increased (e.g. coronary events). Each vascular territory affected by atherosclerosis can be considered as marker of cardiovascular risk.

scholarly journals Circulating Oxidized LDL is a Useful Marker for Cardiovascular Risk Assessment

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1350-1350
Author(s):  
Ann Mertens ◽  
Peter P Verhamme ◽  
Raymond Verhaeghe ◽  
Erik Muls ◽  
Desire Collen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Oxidized Ldl ◽  
Global Risk ◽  
Artery Disease

0032 BACKGROUND: Coronary artery disease is associated with an increase in circulating oxidized (Ox)LDL (Circulation 1998; 98:1487-1494). OBJECTIVES: 1) To determine the usefulness of OxLDL for identifying cardiovascular disease patients and 2) to study the relation of OxLDL with cardiovascular risk factors. METHODS: 1) To determine the diagnostic value of OxLDL 308 subjects were studied: 178 patients with angiographically proven coronary artery disease and 130 age-matched subjects without cardiovascular disease (controls) confirmed by B mode ultrasonography of their carotid arteries. 2) Additional 307 patients without cardiovascular disease were studied to determine the relation of OxLDL with cardiovascular risk factors. Levels of OxLDL were directly measured in plasma using a mAb-4E6 based competition ELISA. RESULTS: Compared with controls, patients had 2.3-fold higher levels of circulating OxLDL. At a cutoff value of 2.30 mg/dL, the sensitivity of OxLDL for cardiovascular disease was 73% with a specificity of 90%. The Global Risk Assessment Score (GRAS) was calculated using age, total and HDL cholesterol, systolic blood pressure, diabetes mellitus and smoking. GRAS was 8.65±3.41 for patients versus 6.09±5.10 (p≤0.001) for controls. Compared with subjects with low OxLDL (≤2.30 mg/dL) and low GRAS (≤12), risk of having cardiovascular disease was 3.2 times higher for subjects with low OxLDL and high GRAS, 6.4 times higher for subjects with high OxLDL and low GRAS and 27 times higher for subjects with both high OxLDL and high GRAS. Among patients without cardiovascular disease, stepwise multivariate analysis showed that Body Mass Index (p<0.001), LDL cholesterol (p<0.001), diabetes type 2 (p=0.003), triglycerides (p=0.017) and smoking (p=0.046) were the strongest predictors of OxLDL. Conclusion: Circulating OxLDL is a sensitive marker of cardiovascular disease. Circulating oxidized LDL correlates with obesity, hypercholesterolemia, diabetes and smoking. Addition of OxLDL to the established risk factors may improve cardiovascular risk prediction. Inclusion of OxLDL in prospective studies of risk factors of cardiovascular disease seems to be warranted.

Coronary artery disease--ignored in women or inherently more lethal in women?

1998 ◽  
Vol 7 (1) ◽  
pp. 77-79 ◽  
Author(s):  
KB Keller ◽  
L Lemberg
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Coronary Artery ◽  
Noninvasive Testing ◽  
Atypical Chest Pain ◽  
Artery Disease

The leading cause of death in women is cardiovascular disease. The major cardiovascular risk factors have a greater impact on women. The prognosis for women with CAD is worse than for men. Women frequently present with symptoms of heart disease at a much later age and have a greater frequency of atypical chest pain. Noninvasive testing is less reliable in women. Do these facts indicate that CAD is inherently a more lethal disease in women? Or is CAD, as some would suggest, traditionally ignored in women? Stay tuned!

scholarly journals Radiation‐Induced Cardiovascular Disease: Review of an Underrecognized Pathology

2021 ◽  
Author(s):  
Eve Belzile‐Dugas ◽  
Mark J. Eisenberg
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Radiation Therapy ◽  
Cardiovascular Risk ◽  
Survival Benefit ◽  
Surgical Approaches ◽  
Pericardial Disease ◽  
Radiation Induced ◽  
Artery Disease

Abstract Radiation therapy demonstrates a clear survival benefit in the treatment of several malignancies. However, cancer survivors can develop a wide array of cardiotoxic complications related to radiation. This pathology is often underrecognized by clinicians and there is little known on how to manage this population. Radiation causes fibrosis of all components of the heart and significantly increases the risk of coronary artery disease, cardiomyopathy, valvulopathy, arrhythmias, and pericardial disease. Physicians should treat other cardiovascular risk factors aggressively in this population and guidelines suggest obtaining regular imaging once symptomatology is established. Patients with radiation‐induced cardiovascular disease tend to do worse than their traditional counterparts for the same interventions. However, there is a trend toward fewer complications and lower mortality with catheter‐based rather than surgical approaches, likely because radiation makes these patients poor surgical candidates. When appropriate, these patients should be referred for percutaneous management of valvulopathy and coronary disease.

scholarly journals Why we should be looking for ear lobe creases. A systematic review and meta-analysis of diagonal ear lobe crease and coronary artery disease.

2020 ◽  
Author(s):  
Jonathan Curtis ◽  
Sophie Walford
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Meta Analysis ◽  
Risk Marker ◽  
Artery Disease ◽  
Sensitivity Specificity ◽  
Insufficient Sensitivity

Objectives The association between diagonal ear lobe crease (DELC) and cardiovascular disease was first suggested in 1973 although some studies have attributed this to confounding cardiovascular factors. This review looked to see if there is a significant association between DELC and angiography-confirmed coronary artery disease (CAD) independent of other risk factors. Design Systematic review and meta-analysis of selected studies using the PRISMA checklist. Setting 12 different hospitals with angiography in eight countries. Participants 4960 adult patients undergoing coronary angiography. Main Outcome Measures • Presence/absence of diagonal ear lobe crease • Diagnostic Odds Ratio • Sensitivity/Specificity Results 12 studies were included in the meta-analysis. Findings from our study suggest: • Patients with DELC have a 4x increased likelihood of having CAD (OR 4.61 P<0.00001). • The relationship between DELC and CAD was independent of age and all other conventional cardiovascular risk factors. • Bilateral DELC has a stronger association with CAD than unilateral DELC. • Presence of DELC has insufficient sensitivity / specificity to be used as a diagnostic test for cardiovascular disease but instead should be used as a risk marker. Conclusions We found that DELC is associated with CAD independently of other known cardiovascular risk factors including age. Histology studies indicate that atherosclerosis is causing DELC and patients with DELC appear to have an increased risk of CAD. It has insufficient sensitivity or specificity to be used as a diagnostic test but should be used as a valuable risk marker to be aware of whilst examining ears.

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