ED Findings From the Boston Area Community Health Survey

Posted on August 28th, 2014 by admin

Conceptual and methodological issues need to be addressed. First, the definition and measurement of Erectile Dysfunction varies from study to study. All definitions of ED, however, are based on patients’ self-report, which is typically assessed by single-item scales or questionnaire measures.

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Some differences are evident among these scales, although studies show overall concordance in the prevalence rates and association with well- known comorbidities and risk factors. Early landmark studies, such as MMAS and National Health and Social Life Survey (NHSLS) used single-item scales, which assessed erection difficulties over several months or in the past year.

Subsequent studies used 5- or 15-item versions of the IIEF, a multidimensional, self-report scale that assesses male sexual function over a 4-week period.

Single-item instruments have the advantage of high completion rates and low patient burden. On the other hand, multidimensional scales provide broader and more complete assessment of disease severity. Despite such differences, largely similar results have been obtained across studies using these different measures.

A second, and potentially more challenging issue, concerns the complex and often bidirectional interactions between variables. For example, depression may be a cause or a consequence of ED in many studies.

These studies support a direct association between ED and mood. In other studies, the causal relationships among the major risk factors for ED are less evident. Biomedical, psychosocial, and lifestyle factors may interact in complex ways. Separating the effects of one risk factor or comorbidity from another and determining the direction of causality among these factors, can be difficult if not impossible to ascertain in cross-sectional studies alone.

More research is needed to elucidate these associations. The increased evidence of a link between ED and CVD with the potential for ED to serve as a sentinel marker of subclinical vascular disease has led to an increased awareness of Erectile Dysfunction as a “barometer” of vascular health and the early opportunity for primary prevention in at-risk men. The 2nd Princeton Consensus Conference has called for the routine assessment of cardiovascular risk in all ED patients and subsequent classification of ED patients into low, moderate, or high risk of CVD and recommendation for aggressive lifestyle modification in patients with ED and CV risk factors. Viagra online canadian pharmacy – cheap sildenafil medications Canada.

However, further understanding is needed of the link between endothelial dysfunction and Erectile Dysfunction and the specific role of endothelial dysfunction in the progression and remission of ED to:

  1. Refine our understanding of pathophysiologicalprocesses of ED in human subjects;
  2. Improve the identification of ED patients at higher risk of CVD who would benefit most from preventive interventions, such as statin therapy, perioperative beta blocker therapy, etc.;
  3. Establish the primacy of endothelial dysfunction in ED incidence and progression and relationship to other predictors.

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