Erectile dysfunction and its correlation with arterial hypertension and cardiovascular diseases

Nowadays many patients suffering from arterial hypertension appear to experience beforehand also erectile dysfunction (ED) which can be regarded as a risk factor for cardiovascular disease (CVD). Over the last years, various clinical trials have demonstrated a resilient correlation between CVD and ED, sharing common pathophysiology. Consequently, ED is highly perceived as an early marker for a patient to experience symptomatic CVD. Endothelial dysfunction, atherosclerosis, low plasma testosterone levels represent common pathophysiological phenomena that are encountered by hypertensive patients who are suffering from ED and CVD events. In every case that ED gets identified at an early stage, it usually precedes by two to five years to a CVD event. Furthermore, its identification represents a low cost-effective prognostic tool for primary and secondary prevention for both CVD and all-cause mortality. Diuretics and β-blockers and diuretics are some of the cardiovascular drugs that affect negatively in ED that physicians need to take seriously into account. Meanwhile nebivolol and renin–angiotensin–aldosterone system inhibitors are proved to affect positively when administered to a patient. PD5 inhibitors represent a breakthrough therapy when dealing with ED and are considered to be safe for the cardiovascular system. Additionally, PD5 inhibitors are beneficial to treat sexual dysfunction and they represent a safe solution for hypertensive patients who take or not antihypertensive drugs. Up to date conducted testosterone replacement therapy (TRT) studies lead to contradictory results related with CVD risks and when such a therapy is used, physicians should closely monitor for possible adverse effects.