Concurrent detection of sexual dysfunction and cardiovascular risk

While the CAD prevalence assessed with the treadmill test is not clearly increased in ED patients (14%), the ED prevalence is high in CAD patients (57%), suggesting that ED precedes CAD, and could be considered as a “sentinel” which could be used for screening for vascular disease, and taking preventive action against serious cardiovascular events (CVE); Most retrospective epidemiologic studies support this hypothesis by reporting high ED prevalence in men diagnosed with CAD documented by angiography (58%), silent ischemia in diabetic patients (34% vs 4% in diabetics without ischemia), MI (67%, mean interval of 38 months since the first ED symptoms), carotid or popliteal atherosclerosis (50%). However only 2 of the 4 prospective longitudinal studies reported to date (Thompson 2005, Schouten 2006) found that ED was a significant marker of incident cardiovascular disease (CVD) at the level of the general population (RR of CVE about 1,5). In an analysis of the MMAS study Araujo found a predictive value only for stroke in smokers (RR 2.95). Lastly the Frantzen data suggest that while ED could be seen as a marker for CVD before 1998 it was clearly not afterwards. The discrepancy in the prospective studies’ conclusions could result from the variable proportion of non vascular ED in the overall populations. Some pilot stud