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Role of exercise treadmill testing in the management of erectile dysfunction: a joint cardiovascular/erectile dysfunction clinic
  1. H Solomon,
  2. J Man,
  3. E Martin,
  4. G Jackson
  1. Department of Cardiology, St Thomas’ Hospital, London, UK
  1. Correspondence to:
    Dr Hemant Solomon, Stanford University Medical Center, 780 Welch Road, Suite 106, Palo Alto, California, USA;

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The most common aetiology for organic erectile dysfunction (ED) is vasculogenic. Men with hypertension have a 15% probability of developing complete ED (increasing to 20% if they smoke).1 Those with diabetes have a 28% probability of developing complete ED compared with only a 9% chance in non-diabetics. Other studies have demonstrated that men with a history of ischaemic heart disease and/or peripheral vascular disease have incidences of ED ranging from 39–64%.2

Many men with a history of cardiovascular disease (CVD) do not receive help for ED. The fear of resuming sexual activity following a cardiac event may cause the individual to avoid seeking medical advice. Lack of awareness by the medical practitioner in managing ED in cardiovascular patients may also decrease confidence among those trying to seek medical advice.

The Princeton and British consensus panels, comprising cardiologists, urologists, pharmacologists, and psychiatrists, evaluated the scientific evidence on sexual activity and its risk in cardiac patients. They produced specific guidelines for the management of ED in cardiac patients, based on the principle that sexual activity poses a very small but definite risk of a cardiac event.3 In particular, they identify a role for exercise treadmill testing (ETT) in cardiovascular risk assessment for men presenting with ED. We report on the success of the implementation of these guidelines …

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