Medicamenteuze behandeling van erectiestoornissen bij cardiovasculair belaste patiënten

- Erectile dysfunction is a frequent condition in cardiovascular patients. Since the arrival of oral erection-supporting medication, patients want to know how safe sexual activity is in cardiovascular disease in general and during use of erection-supporting medication in particular.

- Sexual intercourse with a steady partner causes no more cardiovascular risk than normal daily activities such as ironing, 2 kilometers of walking without climbing, paperhanging, playing golf or gardening.

- The relative risk of myocardial infarction during sexual activity is not significantly higher than for healthy persons.

- The incidence of cardiovascular morbidity and mortality is not higher among users of sildenafil.

- Sildenafil is contraindicated in patients using long-acting nitrates or who may need to use short-acting nitrates, because the combination may cause a sharp fall of the blood pressure. No interactions have been observed with beta-receptor blockers, calcium antagonists, thiazide and loop diuretics and ACE inhibitors.

- Before prescribing a symptomatic (pharmaceutical) treatment for patients with an erection disorder, attention should be given tot the sexuological, psychological and medical backgrounds of the disorder.

- Secondary prevention of atherosclerotic risk factors is also important: regulation of blood pressure and blood sugar level, hyperlipidaemia and obesity, as well as a change of lifestyle (giving up smoking, adapting of diet and more physical exertion).

- Patients with a very low cardiac capacity should be advised to refrain from treatment of the erection disorder.