Objectives To evaluate the association between the risk factors for cardiovascular disease (CVD) and erectile dysfunction (ED).

Methods Relevant studies published for the time range 1992-2012 were searched thoroughly in Medline. Abstracts regarding the main epidemiological evidences on the association between the risk factors for CVD and ED were conducted to briefly review.

Results A growing number of consistent epidemiological evidences suggest CVD and ED share substantially plenty of the same risk factors (OR: 1.93; 95%CI: 1.48-3.27, P < 0.05), which include age, hyperlipidemia, obesity, hypertension, diabetes mellitus, depression and smoking. The pathogenesis of both CVD and ED has been shown to be common conditions of endothelial dysfunction. They were linked through decreased expression and activation of endothelial nitric oxide synthase (eNOS) occurring with ageing. ED may be an early symptom of underlying systemic vascular disease especially coronary artery disease (CAD) rather than itself. Approximately 50-70% of men with CAD have ED. ED can arise before CAD is symptomatic with a time window of 3–5 years.

Conclusions These reviews reveal that ED is beginning to be considered as an early manifestation of underlying CVD. It is a potential risk predictor for the subsequent development of CVD.