Erectile dysfunction and cardiovascular disease

Peer review under responsibility of Arab Association of Urology.

Figures & data

Table 1 Artery size and atherothrombosis. A significant restriction to flow in the penile arteries may be subclinical in larger vessels.

Artery	Diameter (mm)	Clinical Event
Penile	1–2	ED
Coronary	3–4	Ischaemic heart disease
Carotid	5–7	TIA/stroke
Femoral	6–8	Claudication

TIA = transient ischaemic attack.

Table 2 The relative risks for men with ED vs. no ED, in the first [24] and second analysis [25].

Event	Relative risk (95% CI)	P
First analysis
Overall	1.48 (1.25–1.74)	<0.001
CAD	1.46 (1.31–1.63)	<0.001
Stroke	1.35 (1.19–1.54)	<0.001
All-cause mortality	1.19 (1.05–1.34)	0.005
Second analysis
Overall	1.44 (1.27–1.63)	<0.001
CAD (MI)	1.62 (1.34–1.96)	<0.001
Stroke	1.39 (1.23–1.57)	<0.001
All-cause mortality	1.25 (1.12–1.39)	<0.001

Figure 1 The investigative algorithm for CVD and ED.

Figure 2 An angiogram showing a critical right coronary artery stenosis, with a normal exercise test and no calcium, but the patient had ED for 6 months.