Erectile Dysfunction And Heart Disease

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Erectile Dysfunction (ED) to achieve or maintain adequate sexual arousal. Erectile dysfunction is a common physical problem. According to figures from the National Institutes of Health, ED affects 10 to 20 million men in the United States; another 10 million men are affected by incomplete ED, defined as a current but reduced erectile function.

A 1985 study found that ED accounted for 400,000 patient visits and admissions to 30,000 hospitals annually in the United States, at a direct cost of $ 146 million. In 1996, due to the availability of the new oral agent sildenafil, the number of visitors visited outside the ED as estimated by the National Ambulatory Medical Care Survey increased to 1.3 million per year.

In addition to economic costs, ED can have psychological consequences, leading to misbehavior, low self-esteem, depression, and depression, as well as negative effects on personal relationships.

Penile erectile function is the result of complex interactions between vascular, neurologic, hormonal, and psychological factors. The detection and maintenance of a solid structure requires efficient blood flow and effective photography of venous outflow.

Therefore, pathological processes affecting the functioning of the arterial and venous systems are expected to adversely affect erectile function. Unfortunately, cardiovascular disease is more common in men and is characterized by age.

Interactions of cardiovascular health and sexual functioning include the risk of cardiovascular events caused by overdose of other drugs, such as sildenafil, in the cardiovascular system.

CARDIOVASCULAR RISK COLLECTION AND ED

The relationship between cardiovascular disease is clearly visible. Risk factors for heart disease include diabetes, obesity, dysfunction, hyperlipidemia, tobacco use, and high blood pressure.

In general, the estimated risk of each of these factors in the development of ED is difficult to diagnose because many patients with ED and heart disease have a higher risk of 1. Another important consideration is the effect of heart disease itself on erectile function. .

The history of pre-myocardial infarction was not found to be a major risk factor for ED in a study comparing sexual activity in 50 patients who had a prenatal infarction with a control group of 50 patients.

Compared with age, high blood pressure, diabetes, and tobacco use, no significant difference was observed in the presence of ED (42% in the myocardial infarction group vs 48% in the control group). However, the diagnosis of severe heart failure is associated with an increase in ED.

A study of 80 New York Heart Association patients with congenital heart disease in class III / IV found that 40% of these patients had complete ED, and another 40% had mild or moderate ED.

Common associations among heart disease have led some researchers to explore whether the onset of ED could be an effective predictor of heart disease.

A study of 40 patients with heart disease found an association between sexual dysfunction and the presence of heart disease, as well as a link between ED severity and the number of coronary arteries with extensive atherosclerosis.

In another study, 60 patients received a cardiovascular test and Doppler ultrasonography to measure their cavernosal artery peak systolic velocity (PSV). Studies have found that PSV claims to be a better predictor of heart disease than predictors of common heart conditions such as diabetes, high blood pressure, obesity and smoking.

Researchers recommend that people with no history of previous trauma and PSV below 35 mL / s should be screened before receiving ED treatment because these patients had a 42% risk of heart attack.

However, some researchers have questioned the use of penile blood flow to predict the diagnosis of heart disease. They examined 40 patients with coronary artery disease who had coronary artery catheterization and penile brachial index (PBI) measured by Doppler ultrasonography.

Although a positive correlation was observed between PBI and the magnitude of coronary artery obstruction, the relationship was not strong. Also, the abnormality rate of PBI did not successfully differentiate patients according to the severity of their coronary artery obstruction. This study concluded that PBI used alone will not be an effective predictor of severe heart disease.

Diabetes

Diabetes is associated with decreased erectile function and an increased risk of heart disease. MMAS has found that the risk of heart disease is three times higher than in patients with diabetes.

Patients with diabetes often have other risk factors for heart disease that can contribute to the development of ED. However, in the analysis of PBI in 441 patients with ED with various cardiovascular features (diabetes mellitus, high blood pressure, hyperlipidemia, tobacco use), diabetes was the only risk associated with a decrease in PBI.

Diabetes affects the nerves and blood vessels. Diabetes has been found to play a major role in vasculogenic dysfunction in a study of 265 patients with ED who underwent double-blind ultrasonography of the cavernosal arteries after intracavernosal injection of prostaglandin E1.

Patients with atherosclerotic disease (diabetes mellitus, high blood pressure, heart disease, and hyperlipidemia) significantly reduced systolic vestitos and end-diastolic velocities Patients with diabetes increased significantly with diastolic velocities and decreased vascular seizures during stiffness.

These effects persisted even after controlling smoking and high blood pressure. Some studies have shown smooth muscle tone in patients with diabetes.

The onset of ED and diabetes is associated with the presence of progressive retinopathy and symptoms of autonomic neuropathy, as indicated by loss of vibration sensations.

In addition, the presence of nephropathy is related to the onset of ED, such as the length of time a patient has diabetes; many of these patients experience ED within 10 years of being diagnosed with insulin-dependent or non-insulin-dependent diabetes. Glycemia, as measured by glycosylated hemoglobin, is also associated with an increased risk of developing ED in diabetic patients.

Obesity and physical inactivity

The relationship between obesity and ED was difficult to establish because of the close relationship between obesity and diabetes. Subsequent MMAS 9 studies over the next few years show that a body mass index of 28 kg / m2 or more was an independent predictor of ED, with an average rating of 1.96.

Obesity is closely related to the levels of androgens, which can help independently improve ED. Physical inactivity is closely related to obesity and general health problems.

TREATMENT ED

Overview The ability to make a make-up can be improved by pharmacotherapy or surgery in patients with heart disease. Studies show that up to 90% of healthy men aged 70 to 90 have sex.

Erectile dysfunction following cardiovascular disease often responds well to conventional ED treatments performed a few decades ago. Penile prosthesis implants were performed in the 1970s, followed by intracavernosal injections of vasoactive agents, including papaverine, phentolamine, and prostaglandin E1, introduced in the 1980s.

Another treatment option is mechanical vacuum erection devices. In 1997, transurethral insertion of prostaglandin E1 was made available. The first oral agents include the α-blocker yohimbine, which acts primarily only on brain function.

Cenforce 200 mg was introduced in 1998 and was the main PDE5I available. The recommended dose of Cenforce is 50 mg and should be adjusted for patient response and side effects.

Cenforce 200 mg is effective from 30-60 minutes after administration. Its effectiveness is reduced after a high-fat meal due to import delays. Adequate Cenforce 200 can be stored for up to 12 h. While taking Cenforce 200 mg you make a point of quitting alcohol and moreover, Cenforce 200 mg can get tired of different medications, with other medications, especially those used to treat chest pain. If there is a medical emergency, you should tell your doctor, pharmacist, or nurse if and when you have taken your doctor tells you to. You should not take Cenforce 200 mg tablets if you are taking nitrates, as a combination of these drugs can lead to a dangerous drop in blood pressure.

Apomorphine is another oral agent that works on the function of central dopamine receptors. Apomorphine does not appear to have significant cardiovascular effects and has been used successfully in Europe.

However, the use of apomorphine has been linked to other side effects such as nausea and emesis, and the drug has not yet been approved by the US Food and Drug Administration (FDA).

CONCLUSIONS

Heart disease and ED represent 2 processes of common diseases that are closely related. These common pathophysiological links require a strong scientific and therapeutic understanding of these 2 problems and a team effort between the cardiologist and urologist to provide effective management strategies for these patients.