Erectile dysfunction-marker of cardio vascular pathology

Abstract

Introduction: In the last years there has been a progressive increase ED in men after 40 years, the prevalence reaching 52%. Als the incidence of CV pathology remains as up. It’s mortality, represent 60% of overall mortality. If in the 70s- 80s of last century it was considered that 70-90% of ED had psychogenic substrate, presently is considered that predominant factors implicated in ED etiopathogeny there are organic ones. The most common pathogenetic factor of installing the ED is the vascular component, as sharing the same risk factors like Endothelial Dysfunction. A potential explanation why ED may serve as an early symptom of events that endanger the cardiovascular system was developed by Montorsi. According to his hypothesis “artery size” - smaller arteries, such of the penis ones, suffering earlier from obstruction induced by plaque than the largest arteries, for example, coronary arteries, so erectile dysfunction may precede a heart attack. Objectives: Establishing cause-effect link between CV pathology and ED, determination of cardiogenic causes of ED in men with age after 40 years, who addressed the first time at andrologist doctor with erectile difficulties. Materials and methods: Between 2008 and 2010 were examined 169 patients, which addressed primary with erectile dysfunction without undergoing treatment for another pathology previously diagnosed. For the diagnosis of ED was used IIEF questionnaire (international index oferectile function), BMI(body mass index). Laboratory examinations included: cholesterol and its fractions, triglycerides, blood sugar. Instrumental examination included ECG, ECHO heart, Dopplerography of penile arteries. Results: IIEF questionnaires showed a severe degree of ED in 24% (41men), 54% moderate severity (92 men), and mild in 22% (36) men. High BMI was detected in 103 patients 61%, and increased blood pressure in 45 (27%) patients. Elevated levels of cholesterol or its free fractions in 38 (22%) men, increased blood sugar in 29 (17%) men. Conclusions: 1. There is increasing evidence suggests that erectile dysfunction is primarily avascular disease and may be a marker for cardiovascular disease, and depending on the degree of erectile dysfunction can appreciate the progression of pathology CV 2. Patients with erectile dysfunction should be carefully examined, to exclude other major disorders suffering patient which clinically not yet occurred. 3. Exclusion of risk factors and lifestyle changes can improve sexual functional also prevent installation of early CV disease.