ABSTRACT

Erectile dysfunction (ED) is one of the most distressing conditions a man can experience. It is defined by the National Institutes of Health as ‘the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse’. 1 It has a significant adverse impact on quality of life, reducing self-esteem, compromising wellbeing, and limiting interpersonal relationships. 2 In 1995, studies estimated ED to affect over 152 million men worldwide, 3 with a projected 322 million men being affected by 2025. The potential increase in the prevalence of ED, the social stigma attached to it, and its strong association with cardiovascular disease have prompted a significant amount of research. The breadth of this investigation ranges from elucidating pathophysiological mechanisms at the cellular level to, more recently, identifying a prognostic significance of ED at the population level. This chapter discusses the risk factors associated with the occurrence of vascular ED, and proposes the novel concept that vascular ED represents a systemic cardiovascular condition with an unfavorable cardiovascular prognosis.