The Second Princeton Consensus on Sexual Dysfunction and Cardiac Risk: New Guidelines for Sexual Medicine

Jackson, Graham; Rosen, Raymond C.; Kloner, Robert A.; Kostis, John B.

doi:10.1111/j.1743-6109.2005.00196.x

Cited by 327Sexual function and dysfunction studiesHormonal and reproductive studiesCardiovascular Health and Disease Prevention

The Second Princeton Consensus on Sexual Dysfunction and Cardiac Risk: New Guidelines for Sexual Medicine

Jackson, Graham, Rosen, Raymond C., Kloner, Robert A., Kostis, John B.·2006·The Journal of Sexual Medicine

DOI 10.1111/j.1743-6109.2005.00196.x

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Abstract

Introduction Erectile dysfunction (ED) is a highly prevalent disorder associated with a significant burden of illness. The prevalence and incidence of ED are strongly age-related, affecting more than half of men >60 years. The first Princeton Consensus Conference (Princeton I) in 1999 developed guidelines for safe management of cardiac patients regarding sexual activity and the treatment of ED. Aim The second conference (Princeton II) was convened to update the recommendations based on the expanding knowledge base and new treatments available. This article reviews and expands on the Princeton II guidelines to address sexual dysfunction and cardiac risk. Methods A consensus panel of experts reviewed recent multinational studies in safety and drug interaction data for three phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil), with emphasis on the safety of these agents in men with ED and concomitant cardiovascular disease. Results Erectile dysfunction is an early symptom or harbinger of cardiovascular disease, due to the common risk factors and pathophysiology mediated through endothelial dysfunction. Major comorbidities include diabetes, hypertension, hyperlipidemia and heart disease. Any asymptomatic man who presents with ED that does not have an obvious cause (e.g., trauma) should be screened for vascular disease and have blood glucose, lipids, and blood pressure measurements. Ideally, all patients at risk but asymptomatic for coronary disease shou…

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Coexisting cardiac conditions including stable coronary artery disease and heart failure do not post higher risk of cardiac ischemia, coronary vasoconstriction or worsening of the hemodynamic profile on exertion.
“Coexisting cardiac conditions including stable coronary artery disease and heart failure do not post higher risk of cardiac ischemia, coronary vasoconstriction or worsening of the hemodynamic profile on exertion [24,25].”
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Pathophysiological underpinnings of chronic tobacco-induced erectile dysfunction have not been clearly delineated.
“Pathophysiological underpinnings of chronic tobacco-induced ED have not been clearly delineated; however, these mechanisms are ultimately expressed as vascular phenomena [11].”
From Acute Effects of Nicotine on Physiological and Subjective Sexual Arousal in Nonsmoking Men: A Randomized, Double-Blind, Placebo-Controlled Trial (2008) · cites this paper as [11]
Mechanisms of chronic tobacco-induced erectile dysfunction are ultimately expressed as vascular phenomena.
“Pathophysiological underpinnings of chronic tobacco-induced ED have not been clearly delineated; however, these mechanisms are ultimately expressed as vascular phenomena [11].”
From Acute Effects of Nicotine on Physiological and Subjective Sexual Arousal in Nonsmoking Men: A Randomized, Double-Blind, Placebo-Controlled Trial (2008) · cites this paper as [11]

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Authors: Jackson, G., Rosen, R. C., Kloner, R. A., & Kostis, J. B.
Affiliations: St Thomas' Hospital (GB)
University of Medicine and Dentistry of New Jersey (US)
University of Southern California (US)
Corresponding author: Jackson, Graham
ORCID: Kloner, Robert A.
Kostis, John B.
Venue: The Journal of Sexual Medicine
Publisher: Oxford University Press (OUP)
Published: 2006-01-01
Volume: 3
Issue: 1
Pages: 28-36
ISSN: 1743-6095 (ISSN-L)
1743-6109
DOI: 10.1111/j.1743-6109.2005.00196.x
OpenAlex: W2033049068
Cited by: 327
References: 52
Citations by year: 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 9 · 2019: 7 · 2018: 4 · 2017: 6 · 2016: 15 · 2015: 10 · 2014: 23 · 2013: 17 · 2012: 22
FWCI: 29.34
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: The Journal of Sexual Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords: erectile dysfunction, cardiovascular risk, phosphodiesterase-5 inhibitors, sildenafil, tadalafil, vardenafil, drug safety, drug interactions, endothelial dysfunction, cardiovascular screening, exercise electrocardiography, lifestyle modification, weight loss, physical activity
MeSH terms: Adult, Aging, Cardiovascular Agents, Coronary Disease, Drug Interactions, Hemodynamics, Humans, Erectile Dysfunction, Life Style, Male, Middle Aged, Patient Education as Topic, Phosphodiesterase Inhibitors, Risk Factors, Vasodilator Agents, Comorbidity, Practice Guidelines as Topic, Impotence, Vasculogenic, Consensus

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The Second Princeton Consensus on Sexual Dysfunction and Cardiac Risk: New Guidelines for Sexual Medicine

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