Erectile dysfunction in the cardiovascular patient

Eur Heart J. 2013 Jul;34(27):2034-46. doi: 10.1093/eurheartj/eht112. Epub 2013 Apr 24.


Erectile dysfunction is common in the patient with cardiovascular disease. It is an important component of the quality of life and it also confers an independent risk for future cardiovascular events. The usual 3-year time period between the onset of erectile dysfunction symptoms and a cardiovascular event offers an opportunity for risk mitigation. Thus, sexual function should be incorporated into cardiovascular disease risk assessment for all men. A comprehensive approach to cardiovascular risk reduction (comprising of both lifestyle changes and pharmacological treatment) improves overall vascular health, including sexual function. Proper sexual counselling improves the quality of life and increases adherence to medication. This review explores the critical connection between erectile dysfunction and cardiovascular disease and evaluates how this relationship may influence clinical practice. Algorithms for the management of patient with erectile dysfunction according to the risk for sexual activity and future cardiovascular events are proposed.

Keywords: Cardiovascular disease; Erectile dysfunction; Sexual counselling.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / prevention & control
  • Diagnosis, Differential
  • Drug Interactions
  • Erectile Dysfunction / complications*
  • Erectile Dysfunction / diagnosis
  • Erectile Dysfunction / therapy
  • Exercise / physiology
  • Heart Failure / complications
  • Humans
  • Hypertension / complications
  • Impotence, Vasculogenic / complications
  • Impotence, Vasculogenic / diagnosis
  • Impotence, Vasculogenic / therapy
  • Life Style
  • Male
  • Medical History Taking
  • Middle Aged
  • Phosphodiesterase 5 Inhibitors / adverse effects
  • Referral and Consultation
  • Risk Assessment
  • Risk Factors
  • Sex Counseling
  • Sexual Behavior / physiology
  • Sexual Dysfunctions, Psychological / diagnosis
  • Testosterone / deficiency
  • Testosterone / therapeutic use


  • Cardiovascular Agents
  • Phosphodiesterase 5 Inhibitors
  • Testosterone