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首页> 外文期刊>Advanced studies in medicine >Erectile dysfunction and cardiovascular disease: Carrots, sticks, and better men's health
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Erectile dysfunction and cardiovascular disease: Carrots, sticks, and better men's health

机译：勃起功能障碍和心血管疾病：胡萝卜，木棍和更健康的男性

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PURPOSE: To review the causes, risk factors, impact, and management of erectile dysfunction (ED) with a special focus on cardiovascular aspects of the disorder. EPIDEMIOLOGY: About half of men surveyed say they have some degree of ED. The incidence increases with age and with underlying cardiovascular risk factors. REVIEW SUMMARY: Once thought to be primarily a psychogenic disorder, ED is now recognized as a disease that is associated with physical causes in more than 70% of cases. These include vascular diseases (such as hypenipidemia, hypertension, and early coronary disease), diabetes, medication, surgery or trauma, and neurologic or endocrine causes. Following patient assessment and education, clinicians should treat underlying cardiovascular conditions and review current medications before considering medical therapy for ED. To improve success with phosphodiesterase enzyme 5 inhibitors, patients should be given adequate dosage instructions and educated that they may require 4 to 6 trials before maximum results. The main side effects are headache, facial flushing, and dyspepsia. TYPE OF AVAILABLE EVIDENCE: Unstructured review of systematic reviews, meta-analyses, community-based observational surveys, epidemiologic studies, and double-blind placebo-controlled trials. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Cardiovascular disease and ED share many common risk factors. Thus, modifying reversible causes of underlying disease-by controlling blood pressure, diabetes, and lipids-should be a priority in early and ongoing management of patients with ED. For patients seeking ED treatment, the clinician is now well positioned to add a highly tangible "carrot" incentive to the usual "stick" warnings about critical yet less immediately obvious cardiovascular risks, and therefore to achieve improved long-term health outcomes.
机译：目的：回顾勃起功能障碍（ED）的原因，危险因素，影响和治疗，特别关注该疾病的心血管方面。流行病学：大约一半的接受调查的男性说他们患有一定程度的ED。发病率随年龄和潜在的心血管危险因素而增加。综述：一旦被认为是主要的心理疾病，ED现在被认为是一种与身体原因相关的疾病，占70％以上的病例。这些疾病包括血管疾病（例如血脂过多，高血压和早期冠状动脉疾病），糖尿病，药物治疗，手术或外伤以及神经系统或内分泌疾病。在对患者进行评估和教育之后，临床医生应考虑潜在的心血管疾病并在考虑对ED进行药物治疗之前复查当前的药物。为了提高磷酸二酯酶5抑制剂的成功率，应给患者适当的剂量指导，并教育他们可能需要4到6个试验才能获得最大结果。主要的副作用是头痛，面部潮红和消化不良。可用证据的类型：系统评价，荟萃分析，基于社区的观察性调查，流行病学研究和双盲安慰剂对照试验的非结构性评价。可用的证据等级：很好。结论：心血管疾病和ED具有许多共同的危险因素。因此，通过控制血压，糖尿病和脂质来改变潜在疾病的可逆原因，应该成为早期和持续治疗ED患者的优先事项。对于寻求ED治疗的患者而言，临床医生现在处于有利位置，可以在有关严重但不太明显的明显心血管风险的常规“警告”警告中添加高度有形的“胡萝卜”诱因，从而改善长期健康状况。

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