FEATURE: MELISSA LONG, PA-C; E. RACHEL FINK, MPA, PA-C
Erectile Dysfunction: Harbinger of Early Cardiovascular Disease Comanagement of cardiovascular disease risk factors through exercise and weight loss can improve erectile function.
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Erectile dysfunction may be one of the first physical manifestations of atherosclerosis in men.
E
rectile dysfunction is a common disorder defined as “the persistent inability to achieve and then maintain an erection to permit satisfactory sexual intercourse.”1 An estimated 18 million men in the United States (18%) have ED.2 In a cross-sectional analysis, the prevalence of ED differed markedly by age, ranging from 5.1% in men aged 20 to 39 years to 70.2% in men older than 70 years of age.2 However, a recent study found that the incidence of ED in younger men is increasing, estimating the prevalence of ED in younger men (<40 years) to be as high as 30%.3 Although it can be distressing for patients to discuss ED, proper evaluation and treatment of the condition can significantly improve quality of life.4 The growing acknowledgement that ED is a harbinger of cardiovascular disease (CVD), for example, has made the early diagnosis of ED associated with vascular risk factors a priority for many primary care clinicians. Proper evaluation and treatment of ED has been shown to decrease the risk for CVD morbidity.1,5-9 Causes of Erectile Dysfunction
Erectile dysfunction is caused by a variety of factors such as vascular, endocrinologic, neurologic, psychogenic, and anatomic abnormalities. It also can be caused by a combination of factors, which can make determining the cause of ED more difficult. Psychogenic etiologies of ED include depression, anxiety, and interpersonal partner-related 12 THE CLINICAL ADVISOR • MARCH/APRIL 2021 • www.ClinicalAdvisor.com
