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The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease


      The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction.

      Abbreviations and Acronyms:

      ABI (ankle-brachial index), ACCF (American College of Cardiology Foundation), AHA (American Heart Association), BMI (body mass index), BP (blood pressure), CACS (coronary artery calcium scoring), CAD (coronary artery disease), CCTA (coronary computed tomographic angiography), CIMT (carotid intima-media thickness), CVD (cardiovascular disease), ED (erectile dysfunction), EST (exercise stress testing), FRS (Framingham Risk Score), HDL (high-density lipoprotein), hsCRP (high-sensitivity C-reactive protein), LOE (level of evidence), Mets (metabolic equivalents of the task), MI (myocardial infarction), NYHA (New York Heart Association), PAD (peripheral artery disease), PDE5 (phosphodiesterase type 5), PWV (pulse wave velocity), TRT (testosterone replacement therapy), TT (total testosterone), WC (waist circumference)
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      Linked Article

      • Taking Sexual History Should be Routine in All Patients
        Mayo Clinic ProceedingsVol. 88Issue 1
        • Preview
          In their article entitled “The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease,”1 the authors emphasize sexual inquiry of all men. Erectile dysfunction has emerged as a sentinel marker of cardiovascular disease.2 However, the dearth of high-quality controlled studies hampers the development of sexual history-taking curricula for medical students and residents.3 Only 35% of primary care physicians report that they often (75% of the time) or always obtain a sexual history.
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      • Those With Erectile Dysfunction Should Also Be Tested for Serum 25-Hydroxyvitamin D Concentration
        Mayo Clinic ProceedingsVol. 88Issue 1
        • Preview
          The recent report by the Princeton Consensus Conference recommended that men with a diagnosis of erectile dysfunction (ED) be evaluated for cardiovascular disease (CVD).1 Vascular problems underlie most ED not associated with prostatectomy or psychological problems because erections are controlled by the spongy tissue, which can clamp down and restrict blood flow from the penis. We fully agree with the Consensus recommendations that men with ED should be evaluated for CVD.
        • Full-Text
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