Elsevier

American Heart Journal

Volume 167, Issue 2, February 2014, Pages 178-185
American Heart Journal

Clinical Investigation
Coronary Artery Disease
Erectile dysfunction in the cardiology practice—a patients' perspective

https://doi.org/10.1016/j.ahj.2013.10.021Get rights and content

Background

Erectile dysfunction (ED) is an independent risk factor for cardiovascular events sharing mutual risk factors with coronary artery disease. Several guidelines for the management of ED in cardiovascular disease have been proposed, recommending cardiologists to routinely inquire about erectile function. However, males' specific needs and wishes regarding sexual health care in cardiology are unknown. We sought to identify male patients' view concerning possible improvements in sexual health care and preferred forms of sexual counseling in the cardiology practice.

Methods

This is a cross-sectional multicentered survey study among randomly selected males visiting a cardiologist.

Results

Of 388 respondents, 296 questionnaires were eligible for analysis. Mean age of respondents was 62.9 years. Overall, 56% (n = 165) had ED, with up to 86% in patients with heart failure. Mean bother experienced due to ED was 5.93 (±2.57) on a 0 to 10 scale. Most respondents indicated to feel comfortable discussing sexual health with the cardiologists (88%). Of men with ED (n = 165), 46% would like to have a conversation with the cardiologist about possibilities to improve sexual function, 55% would be helped if questions could be asked during consultation with a specialized nurse, and 58% would appreciate written information. Of all respondents (n = 296), 28% ever tried a phosphodiesterase inhibitor; 4% received the prescription of the cardiologists.

Conclusions

Erectile dysfunction is highly prevalent in patients with a variety of cardiovascular diagnosis and care for sexual function is mandatory. Patients indicated that above consultation with the cardiologist, both consultation with a specialized nurse and written information would be helpful.

Section snippets

Setting and participants

In February 2013, a total of 650 surveys were mailed to a cross-sectional cohort of adult male patients who consulted a cardiologist in 1 of 2 participating “Cardiology Centers of the Netherlands” (CCN) (G.A.S, I.I.T., CCN location Amsterdam or G. J. d. G., CNN location Voorschoten) between January 2011 and January 2012. Furthermore, 200 questionnaires were randomly distributed to adult male patients visiting the outpatient cardiology department of the Leiden University Medical Center (academic

Demographic data

Mean age of the 296 respondents was 62.9 years (±11.1). For 86.1% of these men, a cardiac diagnosis was made. The other 13.9% came for cardiac screening or check-up, and no cardiovascular problems were found. Of the respondents, 16.1% used 1, 26.5% used 2, and 29.9% used ≥3 cardiac agents (see Table I).

Erectile function and sexual activity

Erectile dysfunction, as defined by an IIEF-5 score of <21, was prevalent in 165 (65%) of the 255 men who completed the IIEF-5 questionnaire. Of these, 240 had been sexually active in the past

Discussion

This study characterized male patients visiting general cardiac outpatient clinics in terms of demographics, cardiac diagnosis, erectile function, and attitudes toward sexual counseling. It adds to the literature as it is the first study to describe views and preferences of sexual health care in a cross-sectional cohort of males visiting an outpatient cardiology practice. Erectile dysfunction was prevalent in more than half of men in this cohort and the most stated reason not to be sexually

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