Erectile dysfunction, cardiovascular risk, and the primary care clinician

The recognition that erectile dysfunction (ED) has a strong association with vascular disease, and particularly endothelial dysfunction, is relatively new. In the not too distant past, in the textbook Impotence 1 less than 0.3 % of the book – a single page in this 320 page text – focused upon the relationship between cardiovascular disease and ED (see Fig. 13.1 ). Indeed, discussion about the vasculature in ED at that point in time gave special attention to rare disorders such as vascular dysplasia or flow-limiting stenotic lesions, some of which might be surgically remediable, but remain to this date in the category of ‘investigational ’ .