Abstract
Although there is now ample evidence that men with manifest coronary, cerebral and peripheral vascular disease and their risk factors are at highest risk for suffering from erectile dysfunction, recent findings demonstrate a strong connection between erectile dysfunction and endothelial dysfunction. This review explores how urologists and other providers may utilize the link between these conditions in clinical practice, compares methods of assessing endothelial dysfunction and finally speculates on how this additional information might impact treatment plans.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.
Platano G, Margraf J, Alder J, Bitzer J . Frequency and focus of sexual history taking in male patients—a pilot study conducted among Swiss general practitioners and urologists. J Sex Med 2008; 5: 47–59.
Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 2006; 295: 180–189.
Gazzaruso C, Giordanetti S, De Amici E, Bertone G, Falcone C, Geroldi D et al. Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients. Circulation 2004; 110: 22–26.
Gazzaruso C, Pujia A, Solerte SB, Amici ED, Emanuele E, Falcone C et al. Erectile dysfunction and angiographic extent of coronary artery disease in type II diabetic patients. Int J Impot Res 2006; 18: 311–315.
Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003; 44: 360–364; discussion 364–365.
Montorsi P, Ravagnani PM, Galli S, Salonia A, Briganti A, Werba JP et al. Association between erectile dysfunction and coronary artery disease: matching the right target with the right test in the right patient. Eur Urol 2006; 50: 721–731.
Vlachopoulos C, Rokkas K, Ioakeimidis N, Aggeli C, Michaelides A, Roussakis G et al. Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005; 48: 996–1002; discussion 1002–1003.
Borgquist R, Nilsson PM, Gudmundsson P, Winter R, Leosdottir M, Willenheimer R . Coronary flow velocity reserve reduction is comparable in patients with erectile dysfunction and in patients with impaired fasting glucose or well-regulated diabetes mellitus. Eur J Cardiovasc Prev Rehabil 2007; 14: 258–264.
Borgquist R, Gudmundsson P, Winter R, Nilsson P, Willenheimer R . Erectile dysfunction in healthy subjects predicts reduced coronary flow velocity reserve. Int J Cardiol 2006; 112: 166–170.
Solomon H, Man JW, Wierzbicki AS, Jackson G . Relation of erectile dysfunction to angiographic coronary artery disease. Am J Cardiol 2003; 91: 230–231.
Nurkalem Z, Kaya C, Orhan AL, Zencirci E, Alper AT, Kucuk E et al. Erectile dysfunction and coronary slow flow: distinct presentations of endothelial disease. Int J Impot Res 2007; 19: 610–614.
Pritzker M . The penile stress test: a window to the hearts of man? Circulation 1999; 100 (Suppl 1): I-711; abstract 3751.
Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294: 2996–3002.
Heidler S, Temml C, Broessner C, Mock K, Rauchenwald M, Madersbacher S et al. Is the metabolic syndrome an independent risk factor for erectile dysfunction? J Urol 2007; 177: 651–654.
Nikoobakht M, Nasseh H, Pourkasmaee M . The relationship between lipid profile and erectile dysfunction. Int J Impot Res 2007; 19: 617.
Burke JP, Jacobson DJ, McGree ME, Nehra A, Roberts RO, Girman CJ et al. Diabetes and sexual dysfunction: results from the Olmsted County study of urinary symptoms and health status among men. J Urol 2007; 177: 1438–1442.
Riedner CE, Rhoden EL, Ribeiro EP, Fuchs SC . Central obesity is an independent predictor of erectile dysfunction in older men. J Urol 2006; 176 (4 Part 1): 1519–1523.
El-Sakka AI . Association of risk factors and medical comorbidities with male sexual dysfunctions. J Sex Med 2007; 4: 1691–1700.
He J, Reynolds K, Chen J, Chen CS, Wu X, Duan X et al. Cigarette smoking and erectile dysfunction among Chinese men without clinical vascular disease. Am J Epidemiol 2007; 166: 803–809.
Ponholzer A, Temml C, Mock K, Marszalek M, Obermayr R, Madersbacher S . Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol 2005; 47: 80–85; discussion 85–86.
Barrett-Connor E . Heart disease risk factors predict erectile dysfunction 25 years later (the Rancho Bernardo Study). Am J Cardiol 2005; 96: 3M–7M.
Guay AT . ED2: erectile dysfunction=endothelial dysfunction. Endocrinol Metab Clin North Am 2007; 36: 453–463.
Billups KL, Bank AJ, Padma-Nathan H, Katz S, Williams R . Erectile dysfunction is a marker for cardiovascular disease: results of the Minority Health Institute expert advisory panel. J Sex Med 2005; 2: 40–50; discussion 50–42.
Ross R . Atherosclerosis—an inflammatory disease. N Engl J Med 1999; 340: 115–126.
Cooke JP . The endothelium: a new target for therapy. Vasc Med (London) 2000; 5: 49–53.
Lekakis J, Papamichael C, Vemmos C, Stamatelopoulos K, Voutsas A, Stamatelopoulos S . Effects of acute cigarette smoking on endothelium-dependent arterial dilatation in normal subjects. Am J Cardiol 1998; 81: 1225–1228.
Higashi Y, Sasaki S, Nakagawa K, Matsuura H, Chayama K, Oshima T . Effect of obesity on endothelium-dependent, nitric oxide-mediated vasodilation in normotensive individuals and patients with essential hypertension. Am J Hypertens 2001; 14: 1038–1045.
Kaiser DR, Billups K, Mason C, Wetterling R, Lundberg JL, Bank AJ . Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004; 43: 179–184.
Yanagisawa M, Kurihara H, Kimura S, Goto K, Masaki T . A novel peptide vasoconstrictor, endothelin, is produced by vascular endothelium and modulates smooth muscle Ca2+ channels. J Hypertens Suppl 1988; 6: S188–S191.
Kedzierski RM, Yanagisawa M . Endothelin system: the double-edged sword in health and disease. Ann Rev Pharmacol Toxicol 2001; 41: 851–876.
Ito H, Hirata Y, Adachi S, Tanaka M, Tsujino M, Koike A et al. Endothelin-1 is an autocrine/paracrine factor in the mechanism of angiotensin II-induced hypertrophy in cultured rat cardiomyocytes. J Clin Invest 1993; 92: 398–403.
Ehrenreich H, Anderson RW, Fox CH, Rieckmann P, Hoffman GS, Travis WD et al. Endothelins, peptides with potent vasoactive properties, are produced by human macrophages. J Exp Med 1990; 172: 1741–1748.
Bohm F, Pernow J . The importance of endothelin-1 for vascular dysfunction in cardiovascular disease. Cardiovasc Res 2007; 76: 8–18.
Palmer RM, Ferrige AG, Moncada S . Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987; 327: 524–526.
Juonala M, Viikari JS, Alfthan G, Marniemi J, Kahonen M, Taittonen L et al. Brachial artery flow-mediated dilation and asymmetrical dimethylarginine in the cardiovascular risk in young Finns study. Circulation 2007; 116: 1367–1373.
Ardigo D, Stuehlinger M, Franzini L, Valtuena S, Piatti PM, Pachinger O et al. ADMA is independently related to flow-mediated vasodilation in subjects at low cardiovascular risk. Eur J Clin Invest 2007; 37: 263–269.
Valkonen VP, Paiva H, Salonen JT, Lakka TA, Lehtimaki T, Laakso J et al. Risk of acute coronary events and serum concentration of asymmetrical dimethylarginine. Lancet 2001; 358: 2127–2128.
Mittermayer F, Krzyzanowska K, Exner M, Mlekusch W, Amighi J, Sabeti S et al. Asymmetric dimethylarginine predicts major adverse cardiovascular events in patients with advanced peripheral artery disease. Arterioscler Thromb Vasc Biol 2006; 26: 2536–2540.
Schnabel R, Blankenberg S, Lubos E, Lackner KJ, Rupprecht HJ, Espinola-Klein C et al. Asymmetric dimethylarginine and the risk of cardiovascular events and death in patients with coronary artery disease: results from the AtheroGene Study. Circ Res 2005; 97: e53–e59.
Elesber AA, Solomon H, Lennon RJ, Mathew V, Prasad A, Pumper G et al. Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis. Eur Heart J 2006; 27: 824–831.
Maas R, Wenske S, Zabel M, Ventura R, Schwedhelm E, Steenpass A et al. Elevation of asymmetrical dimethylarginine (ADMA) and coronary artery disease in men with erectile dysfunction. Eur Urol 2005; 48: 1004–1011; discussion 1011–1002.
Gates PE, Boucher ML, Silver AE, Monahan KD, Seals DR . Impaired flow-mediated dilation with age is not explained by L-arginine bioavailability or endothelial asymmetric dimethylarginine protein expression. J Appl Physiol 2007; 102: 63–71.
Nawawi H, Osman NS, Annuar R, Khalid BA, Yusoff K . Soluble intercellular adhesion molecule-1 and interleukin-6 levels reflect endothelial dysfunction in patients with primary hypercholesterolaemia treated with atorvastatin. Atherosclerosis 2003; 169: 283–291.
Naya M, Tsukamoto T, Morita K, Katoh C, Furumoto T, Fujii S et al. Plasma interleukin-6 and tumor necrosis factor-alpha can predict coronary endothelial dysfunction in hypertensive patients. Hypertens Res 2007; 30: 541–548.
Silvestro A, Brevetti G, Schiano V, Scopacasa F, Chiariello M . Adhesion molecules and cardiovascular risk in peripheral arterial disease. Soluble vascular cell adhesion molecule-1 improves risk stratification. Thromb Haemost 2005; 93: 559–563.
Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Vasiliadou C, Alexopoulos N et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J 2006; 27: 2640–2648.
Giugliano F, Esposito K, Di Palo C, Ciotola M, Giugliano G, Marfella R et al. Erectile dysfunction associates with endothelial dysfunction and raised proinflammatory cytokine levels in obese men. J Endocrinol Invest 2004; 27: 665–669.
Billups KL, Kaiser DR, Kelly AS, Wetterling RA, Tsai MY, Hanson N et al. Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res 2003; 15: 231–236.
Blankenberg S, Rupprecht HJ, Bickel C, Peetz D, Hafner G, Tiret L et al. Circulating cell adhesion molecules and death in patients with coronary artery disease. Circulation 2001; 104: 1336–1342.
Witte DR, Broekmans WM, Kardinaal AF, Klopping-Ketelaars IA, van Poppel G, Bots ML et al. Soluble intercellular adhesion molecule 1 and flow-mediated dilatation are related to the estimated risk of coronary heart disease independently from each other. Atherosclerosis 2003; 170: 147–153.
Bickel C, Rupprecht HJ, Blankenberg S, Espiniola-Klein C, Schlitt A, Rippin G et al. Relation of markers of inflammation (C-reactive protein, fibrinogen, von Willebrand factor, and leukocyte count) and statin therapy to long-term mortality in patients with angiographically proven coronary artery disease. Am J Cardiol 2002; 89: 901–908.
Naya M, Tsukamoto T, Inubushi M, Morita K, Katoh C, Furumoto T et al. Elevated plasma plasminogen activator inhibitor type-1 is an independent predictor of coronary microvascular dysfunction in hypertension. Circ J 2007; 71: 348–353.
Hwang SJ, Ballantyne CM, Sharrett AR, Smith LC, Davis CE, Gotto Jr AM et al. Circulating adhesion molecules VCAM-1, ICAM-1, and E-selectin in carotid atherosclerosis and incident coronary heart disease cases: the Atherosclerosis Risk In Communities (ARIC) study. Circulation 1997; 96: 4219–4225.
Rader DJ . Inflammatory markers of coronary risk. N Engl J Med 2000; 343: 1179–1182.
Horstman LL, Jy W, Jimenez JJ, Ahn YS . Endothelial microparticles as markers of endothelial dysfunction. Front Biosci 2004; 9: 1118–1135.
Lin Y, Weisdorf DJ, Solovey A, Hebbel RP . Origins of circulating endothelial cells and endothelial outgrowth from blood. J Clin Invest 2000; 105: 71–77.
Reyes M, Dudek A, Jahagirdar B, Koodie L, Marker PH, Verfaillie CM . Origin of endothelial progenitors in human postnatal bone marrow. J Clin Invest 2002; 109: 337–346.
Asahara T, Murohara T, Sullivan A, Silver M, van der Zee R, Li T et al. Isolation of putative progenitor endothelial cells for angiogenesis. Science 1997; 275: 964–967.
Asahara T, Masuda H, Takahashi T, Kalka C, Pastore C, Silver M et al. Bone marrow origin of endothelial progenitor cells responsible for postnatal vasculogenesis in physiological and pathological neovascularization. Circ Res 1999; 85: 221–228.
Eguchi M, Masuda H, Asahara T . Endothelial progenitor cells for postnatal vasculogenesis. Clin Exp Nephrol 2007; 11: 18–25.
Masuda H, Kalka C, Asahara T . Endothelial progenitor cells for regeneration. Hum Cell 2000; 13: 153–160.
Foresta C, Caretta N, Lana A, Cabrelle A, Palu G, Ferlin A . Circulating endothelial progenitor cells in subjects with erectile dysfunction. Int J Impot Res 2005; 17: 288–290.
Baumhakel M, Werner N, Bohm M, Nickenig G . Circulating endothelial progenitor cells correlate with erectile function in patients with coronary heart disease. Eur Heart J 2006; 27: 2184–2188.
Hill JM, Zalos G, Halcox JP, Schenke WH, Waclawiw MA, Quyyumi AA et al. Circulating endothelial progenitor cells, vascular function, and cardiovascular risk. N Engl J Med 2003; 348: 593–600.
Mutin M, Canavy I, Blann A, Bory M, Sampol J, Dignat-George F . Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells. Blood 1999; 93: 2951–2958.
Furumoto T, Fujii S, Saito N, Mikami T, Kitabatake A . Relationships between brachial artery flow mediated dilation and carotid artery intima-media thickness in patients with suspected coronary artery disease. Jpn Heart J 2002; 43: 117–125.
Hashimoto M, Eto M, Akishita M, Kozaki K, Ako J, Iijima K et al. Correlation between flow-mediated vasodilatation of the brachial artery and intima-media thickness in the carotid artery in men. Arterioscler Thromb Vasc Biol 1999; 19: 2795–2800.
Enderle MD, Schroeder S, Ossen R, Meisner C, Baumbach A, Haering HU et al. Comparison of peripheral endothelial dysfunction and intimal media thickness in patients with suspected coronary artery disease. Heart 1998; 80: 349–354.
Migdalis IN, Kalogeropoulou K, Karmaniolas KD, Varvarigos N, Mortzos G, Cordopatis P . Plasma levels of endothelin and early carotid atherosclerosis in diabetic patients. Res Commun Mol Pathol Pharmacol 2000; 108: 15–25.
Porta B, Baldassarre D, Camera M, Amato M, Arquati M, Brusoni B et al. E-selectin and TFPI are associated with carotid intima-media thickness in stable IHD patients: the baseline findings of the MIAMI study. Nutr Metab Cardiovasc Dis 2007, advance online publication 21 September 2007 (in press).
Thakore AH, Guo CY, Larson MG, Corey D, Wang TJ, Vasan RS et al. Association of multiple inflammatory markers with carotid intimal medial thickness and stenosis (from the Framingham Heart Study). Am J Cardiol 2007; 99: 1598–1602.
Bocchio M, Scarpelli P, Necozione S, Pelliccione F, Mhialca R, Spartera C et al. Intima-media thickening of common carotid arteries is a risk factor for severe erectile dysfunction in men with vascular risk factors but no clinical evidence of atherosclerosis. J Urol 2005; 173: 526–529.
Espeland MA, Craven TE, Riley WA, Corson J, Romont A, Furberg CD . Reliability of longitudinal ultrasonographic measurements of carotid intimal-medial thicknesses. Asymptomatic Carotid Artery Progression Study Research Group. Stroke 1996; 27: 480–485.
Tee GB, Rasool AH, Halim AS, Rahman AR . Dependence of human forearm skin postocclusive reactive hyperemia on occlusion time. J Pharmacol Toxicol Methods 2004; 50: 73–78.
Belcaro G, Cesarone MR, Nicolaides AN, Vale J, Glass J, Lennox A . Microcirculatory studies in erectile disorders. Curr Med Res Opin 2000; 16 (Suppl 1): s72–s75.
Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002; 39: 257–265.
Anderson TJ, Uehata A, Gerhard MD, Meredith IT, Knab S, Delagrange D et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26: 1235–1241.
Wu WC, Sharma SC, Choudhary G, Coulter L, Coccio E, Eaton CB . Flow-mediated vasodilation predicts the presence and extent of coronary artery disease assessed by stress thallium imaging. J Nucl Cardiol 2005; 12: 538–544.
Chiurlia E, D’Amico R, Ratti C, Granata AR, Romagnoli R, Modena MG . Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J Am Coll Cardiol 2005; 46: 1503–1506.
Yavuzgil O, Altay B, Zoghi M, Gurgun C, Kayikcioglu M, Kultursay H . Endothelial function in patients with vasculogenic erectile dysfunction. Int J Cardiol 2005; 103: 19–26.
Kaya C, Uslu Z, Karaman I . Is endothelial function impaired in erectile dysfunction patients? Int J Impot Res 2006; 18: 55–60.
Kuvin JT, Patel AR, Sliney KA . Peripheral arterial tonometry: a simplified technique for assessing endothelium-dependent vasomotion. Program and Abstracts of the American College of Cardiology 50th Annual Scientific Session 18–21. JACC 2001; 37(Suppl): 243A.
Kuvin JT, Mammen A, Mooney P, Alsheikh-Ali AA, Karas RH . Assessment of peripheral vascular endothelial function in the ambulatory setting. Vasc Med (London) 2007; 12: 13–16.
Bonetti PO, Pumper GM, Higano ST, Holmes Jr DR, Kuvin JT, Lerman A . Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol 2004; 44: 2137–2141.
Qureshi E, Diamond GA, Chouraqui P, Saef J, Reed G, Armenia AB et al. Usefulness of finger blood flow during exercise as a marker of functionally significant coronary heart disease. Am J Cardiol 2002; 90: 756–759.
Chouraqui P, Schnall RP, Dvir I, Rozanski A, Qureshi E, Arditti A et al. Assessment of peripheral artery tonometry in the detection of treadmill exercise-induced myocardial ischemia. J Am Coll Cardiol 2002; 40: 2195–2200.
Rozanski A, Qureshi E, Bauman M, Reed G, Pillar G, Diamond GA . Peripheral arterial responses to treadmill exercise among healthy subjects and atherosclerotic patients. Circulation 2001; 103: 2084–2089.
Goor DA, Sheffy J, Schnall RP, Arditti A, Caspi A, Bragdon EE et al. Peripheral arterial tonometry: a diagnostic method for detection of myocardial ischemia induced during mental stress tests: a pilot study. Clin Cardiol 2004; 27: 137–141.
Nohria A, Gerhard-Herman M, Creager MA, Hurley S, Mitra D, Ganz P . Role of nitric oxide in the regulation of digital pulse volume amplitude in humans. J Appl Physiol 2006; 101: 545–548.
Kuvin JT, Patel AR, Sliney KA, Pandian NG, Sheffy J, Schnall RP et al. Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J 2003; 146: 168–174.
Bonetti PO, Barsness GW, Keelan PC, Schnell TI, Pumper GM, Kuvin JT et al. Enhanced external counterpulsation improves endothelial function in patients with symptomatic coronary artery disease. J Am Coll Cardiol 2003; 41: 1761–1768.
Haller MJ, Silverstein JH, Shuster JJ . Correlation between radial artery tonometry- and fingertip tonometry-derived augmentation index in children with type 1 diabetes. Diab Vasc Dis Res 2007; 4: 66.
Haller MJ, Stein J, Shuster J, Theriaque D, Silverstein J, Schatz DA et al. Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes. Pediatr Diabetes 2007; 8: 193–198.
Shachor-Meyouhas Y, Pillar G, Shehadeh N . Uncontrolled type 1 diabetes mellitus and endothelial dysfunction in adolescents. Isr Med Assoc J 2007; 9: 637–640.
Chenzbraun A, Levin G, Scheffy J, Keren A, Stern S, Goor D . The peripheral vascular response to exercise is impaired in patients with risk factors for coronary artery disease. Cardiology 2001; 95: 126–130.
Lowenstein L, Damti A, Pillar G, Shott S, Blumenfeld Z . Evaluation of endothelial function in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2007; 134: 208–212.
Kuvin JT, Karas RH . Clinical utility of endothelial function testing: ready for prime time? Circulation 2003; 107: 3243–3247.
Mazo E, Gamidov S, Iremashvili V . The effect of vardenafil on endothelial function of brachial and cavernous arteries. Int J Impot Res 2006; 18: 464–469.
Ucar G, Secil M, Demir O, Demir T, Comlekci A, Uysal S et al. The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction. Int J Impot Res 2007; 19: 577–583.
Khera M, Sathyamoorthy K, Mohamed O, Schumacher M, Ekeruo W, Lipshutz LI . Endothelial function scores can predict which patients will have arterial insufficiency and venous leak on penile duplex ultrasound. J Sex Med 2008; 5 (Suppl 1): 4–41.
Montorsi P, Montorsi F, Schulman CC . Is erectile dysfunction the ‘tip of the iceberg’ of a systemic vascular disorder? Eur Urol 2003; 44: 352–354.
Jackson G, Rosen RC, Kloner RA, Kostis JB . The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 2006; 3: 28–36; discussion 36.
Kostis JB, Jackson G, Rosen R, Barrett-Connor E, Billups K, Burnett AL et al. Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference). Am J Cardiol 2005; 96: 85M–93M.
Smith NJ, Sak SC, Baldo O, Eardley I . The prevalence of newly diagnosed hyperlipidaemia in men with erectile dysfunction. BJU Int 2007; 100: 357–361.
Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA . Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998; 338: 1397–1404.
Ballard SA, Gingell CJ, Tang K, Turner LA, Price ME, Naylor AM . Effects of sildenafil on the relaxation of human corpus cavernosum tissue in vitro and on the activities of cyclic nucleotide phosphodiesterase isozymes. J Urol 1998; 159: 2164–2171.
Beavo JA . Cyclic nucleotide phosphodiesterases: functional implications of multiple isoforms. Physiol Rev 1995; 75: 725–748.
Sommer F, Schulze W . Treating erectile dysfunction by endothelial rehabilitation with phosphodiesterase 5 inhibitors. World J Urol 2005; 23: 385–392.
Behr-Roussel D, Gorny D, Mevel K, Caisey S, Bernabe J, Burgess G et al. Chronic sildenafil improves erectile function and endothelium-dependent cavernosal relaxations in rats: lack of tachyphylaxis. Eur Urol 2005; 47: 87–91.
McMahon C . Efficacy and safety of daily tadalafil in men with erectile dysfunction previously unresponsive to on-demand tadalafil. J Sex Med 2004; 1: 292–300.
McMahon C . Comparison of efficacy, safety, and tolerability of on-demand tadalafil and daily dosed tadalafil for the treatment of erectile dysfunction. J Sex Med 2005; 2: 415–425; discussion 425–417.
Foresta C, Lana A, Cabrelle A, Ferigo M, Caretta N, Garolla A et al. PDE-5 inhibitor, vardenafil, increases circulating progenitor cells in humans. Int J Impot Res 2005; 17: 377–380.
Foresta C, Ferlin A, De Toni L, Lana A, Vinanzi C, Galan A et al. Circulating endothelial progenitor cells and endothelial function after chronic Tadalafil treatment in subjects with erectile dysfunction. Int J Impot Res 2006; 18: 484–488.
Bocchio M, Pelliccione F, Passaquale G, Mihalca R, Necozione S, Desideri G et al. Inhibition of phosphodiesterase type 5 with tadalafil is associated to an improved activity of circulating angiogenic cells in men with cardiovascular risk factors and erectile dysfunction. Atherosclerosis 2008; 196: 313–319.
Aversa A, Greco E, Bruzziches R, Pili M, Rosano G, Spera G . Relationship between chronic tadalafil administration and improvement of endothelial function in men with erectile dysfunction: a pilot study. Int J Impot Res 2007; 19: 200–207.
Rosano GM, Aversa A, Vitale C, Fabbri A, Fini M, Spera G . Chronic treatment with tadalafil improves endothelial function in men with increased cardiovascular risk. Eur Urol 2005; 47: 214–220; discussion 220–212.
Proietti M, Aversa A, Letizia C, Rossi C, Menghi G, Bruzziches R et al. Erectile dysfunction in systemic sclerosis: effects of longterm inhibition of phosphodiesterase type-5 on erectile function and plasma endothelin-1 levels. J Rheumatol 2007; 34: 1712–1717.
Aversa A, Bruzziches R, Vitale C, Marazzi G, Francomano D, Barbaro G et al. Chronic sildenafil in men with diabetes and erectile dysfunction. Expert Opin Drug Metabol Toxicol 2007; 3: 451–464.
Aversa A, Vitale C, Volterrani M, Fabbri A, Spera G, Fini M et al. Chronic administration of sildenafil improves markers of endothelial function in men with type 2 diabetes. Diabet Med 2008; 25: 37–44.
Author information
Authors and Affiliations
Corresponding authors
Rights and permissions
About this article
Cite this article
Tamler, R., Bar-Chama, N. Assessment of endothelial function in the patient with erectile dysfunction: an opportunity for the urologist. Int J Impot Res 20, 370–377 (2008). https://doi.org/10.1038/ijir.2008.13
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ijir.2008.13
Keywords
This article is cited by
-
Differences in the prevalence of erectile dysfunction between novel subgroups of recent-onset diabetes
Diabetologia (2022)
-
The endothelial cell in health and disease: its function, dysfunction, measurement and therapy
International Journal of Impotence Research (2010)
-
The prevalence of erectile dysfunction in heart failure patients by race and ethnicity
International Journal of Impotence Research (2008)