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Abstract：
Recent studies have highlighted the relation between erectile dysfunction (ED) and cardiovascular disease. In particular, the role of endothelial dysfunction and nitric oxide in ED and atherosclerotic disease has been elucidated. Given the large number of men receiving medical treatment for ED, concerns regarding the risk for sexual activity triggering acute cardiovascular events and potential risks of adverse or unanticipated drug interactions need to be addressed. A risk stratification algorithm was developed by the First Princeton Consensus Panel to evaluate the degree of cardiovascular risk associated with sexual activity for men with varying degrees of cardiovascular disease. Patients were assigned to 3 categories: low, intermediate (including those requiring further evaluation), and high risk. This consensus study from the Second Princeton Consensus Conference corroborates and clarifies the algorithm and emphasizes the importance of risk factor evaluation and management for all patients with ED. The panel reviewed recent safety and drug interaction data for 3 phosphodiesterase (PDE)-5 inhibitors (sildenafil, tadalafil, vardenafil), with emphasis on the safety of these agents in men with ED and concomitant cardiovascular disease. Increasing evidence supports the role of lifestyle intervention in ED, specifically weight loss and increased physical activity, particularly in patients with ED and concomitant cardiovascular disease. Special management recommendations for patients taking PDE-5 inhibitors who present at the emergency department and other emergency medical situations are described. Finally, further research on the role of PDE-5 inhibition in treating patients with other medical or cardiovascular disorders is recommended.
摘要：
最近的研究强调了勃起功能障碍（ED）与心血管疾病之间的关系。特别是,已经阐明了内皮功能障碍和一氧化氮在ED和动脉粥样硬化疾病中的作用。鉴于接受ED治疗的男性人数众多，需要解决有关性活动引发急性心血管事件的风险以及不良或意外药物相互作用的潜在风险的问题.普林斯顿第一共识小组开发了一种风险分层算法，以评估患有不同程度心血管疾病的男性与性活动相关的心血管风险程度。患者被分为3类：低，中级(包括需要进一步评估的)，和高风险。第二次普林斯顿共识会议的共识研究证实并阐明了算法，并强调了对所有ED患者进行风险因素评估和管理的重要性。该小组回顾了3种磷酸二酯酶（PDE）-5抑制剂（西地那非，他达拉非,伐地那非)，强调这些药物在患有ED和伴随心血管疾病的男性中的安全性。越来越多的证据支持生活方式干预在ED中的作用，特别是减肥和增加体力活动，尤其是患有ED和伴随心血管疾病的患者。描述了在急诊科和其他紧急医疗情况下服用PDE-5抑制剂的患者的特殊管理建议。最后,建议进一步研究抑制PDE-5在治疗其他医学或心血管疾病患者中的作用.
