Invited Speaker

Erectile Dysfunction as a Predictor of Cardiovascular Disease
Naim Hannaoui Hadi
Spain

Until recently, metabolic syndrome, diabetes mellitus, cardiovascular disease, obesity, erectile dysfunction, and hypogonadism were viewed as more or less independent entities befalling the aging male, if necessary, treated by various medical specialists.

With a more integral approach to the health of middle-age and elderly men, these conditions appear closely interrrelated in their manifestations, hypothetically in their etiology, diagnostic strategy and also their treatment.

Many risk factors which are well established as a potential harm for the development of endothelial dysfunction significantly leading to cardiovascular disease and erectile dysfunction. Therefore, a diagnosis erectile dysfunction may be seen as a sentinel event that should prompt investigation for coronary heart disease in asymptomatic men.

The vascular endothelium is known to be a dynamic cell layer that controls important functions of the vascular bed including vascular tone, hemostasis, proliferative processes and vascular permeability.

Endothelial integrity has an important role in preserving systemic cardiovascular function. Endothelial dysfunction mainly results in a reduced capacity of the endothelial cells to release vasodilatory molecules, affecting smooth muscle cell relaxation.

Endothelial dysfunction is a major etiological factor in the development of vasculogenic erectile dysfunction. Drugs that can improve endothelial function have been shown to improve erectile function in men with hypercholesterolemia.

Moreover several studys and clinical data suggest that chronic treatment with phosphodiesterase type 5 inhibitors can improve systemic endotelial function in individuals with cardiovascular disease.

In addition to the traditional on-demand strategy the current trend of treating erectile dysfunction with daily PDE5I dosing has further exposed the impact of these drugs on endothelial function.