The interplay of health and heart health on sexual function: understanding the impact of CVD on sexual dysfunction in men

[madman]

* Erectile dysfunction is a marker of underlying cardiac disease, but many doctors are just not asking!




@Nelson Vergel

This is powerful!

6:00-6:15

* You need to lose about 75% of the lumen of the coronary artery before you get your first cardiac symptom but if you lose even a small amount of the very small penile artery you get sexual problems

Dr. Mike Kirby

Summary

Take Home Message

 

[madman]

* PDE5 inhibitor drugs may be cardioprotective and nitrates have no prognostic benefit




Learning Objectives

 

[madman]

* More than 70% and women disagreed with the statement

 

[madman]

@Nelson Vergel


Hitting the nail on the head here!

ED=ED

* A man with ED is a vascular patient until proven otherwise!

 

[madman]

* This is the endothelium of the corpora cavernosa of a New Zealand white rabbit which made a mistake and came to the UK where it was made diabetic (Image 1) and here you see (Image 2) an unhealthy endothelium within the corpora cavernosa, you can see a red blood cell stuck to the endothelium a white blood cell stuck down here, this is not what you want to see


* We will have a kilogram of VA endothelium and we need to keep it healthy




Image 1

Image 2

 

[madman]

Endothelium-Dependant Vasodilation*

 

[madman]

* The risk factors for Coronary Artery Disease and Erectile Dysfunction overlap and indeed are similar and we know that erectile dysfunction is an independent marker of endothelial dysfunction and early systemic vascular disease




Risk Factors (CAD/ED)

 

[madman]

Summary

 

[madman]

4th Concept: Questioning the Link

 

[madman]

ED Prevalence: Time of onset in 300 consecutive men with acute chest pain and CAD

 

[madman]

The Temporal Relationship Between ED and CVD

 

[madman]

* Losing night-time erections is the earliest and most important sign of vascular disease and is detrimental to erectile dysfunction


* Due to loss of corporal smooth muscle and tunica albuginea atrophy results in sublimation and redundancy leading to venous leakage

 

[madman]

Cardiac Risk Calculator (QRISK3)

 

[madman]

Evolution in the Understanding of CVD

 

[madman]

Prevalence of cardiac dysfunction in men with erectile dysfunction: the EDcard study

 

[madman]

Importance of maintaining a healthy sex life: Results

 

[madman]

Assessing the risks

Sex and the heart

MET equivalents

Metabolic response to sexual activity

Cardiovascular effects of sex

 

[madman]

Sexual activity & the Heart

Playing away from home...!

 

[madman]

Effect of Baseline Bioavailable Testosterone on All-Cause Mortality in Men with Proven Coronary Heart Disease n=930 mean follow up 6.9 years

 

[madman]

PDE5 inhibitors cardioprotective?