Erectile dysfunction and the heart-what's new?

Erectile dysfunction (ED) and vascular disease often co-exist, especially in men over 40 years of age. Endothelial dysfunction is recognised as being the common denominator. Since the endothelium is present throughout the arterial tree, dysfunction at one point that is symptomatic (erectile dysfunction) may be a marker for silent problems elsewhere (coronary arteries). The literature linking ED to silent vascular disease has grown with a consistent message - a man with ED and no cardiac symptoms is a cardiac (or vascular) patient until proved otherwise. ED precedes a chronic or acute cardiac presentation of chest pain by an average of 2-3 years. Since ED shares the same risk factors as coronary disease, the opportunity to use ED as a reason for aggressive risk factor reduction is now the focus of further study - can a man with ED have his coronary event avoided?