Men and women with cardiovascular disease are currently treated with multiple medications
to reduce their cardiovascular risk. Although the links between erectile dysfunction (ED) and
coronary heart disease (CHD) are well established and ED often precedes the onset of CHD by
3-5 years, few men in UK general practice are asked about their erections prior to
commencement of therapy for cardiovascular disease. The presumption is often that if the
patient has a sexual problem, then he will mention it and at that point the therapy can be
changed. There are two drawbacks with this approach: first, men do not readily volunteer
sexual problems, and second, unless the therapy change is made quickly, the problem is
unlikely to resolve.5 Physicians must be aware that in many cases, such as the use of betablockers
after acute myocardial infarction, the appropriate management of the cardiac
condition is the major priority.
