The DOI matches its Crossref record; 51 of the 52 references it cites were found in a registry or an index.
The Second Princeton Consensus on Sexual Dysfunction and Cardiac Risk: New Guidelines for Sexual Medicine
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 [24,25].”
From Erectile dysfunction and its pharmacology: An overview (2017) · cites this paper as [25]
In the citing paper
“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]
In the citing paper
“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]
Citations
Cites
Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., Wang, T., & for the GSSAB Investigators' Group (2005) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3901250 · Cited by 1,415
Aytaç, Mckinlay, & Krane (1999) · British Journal of Urology · doi:10.1046/j.1464-410x.1999.00142.x · Cited by 1,341
Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men: A Randomized Controlled Trial
Esposito, K., Giugliano, F., Di Palo, C., Giugliano, G., Marfella, R., D'Andrea, F., D'Armiento, M., & Giugliano, D. (2004) · JAMA · doi:10.1001/jama.291.24.2978 · Cited by 841
Bacon, C. G., Mittleman, M. A., Kawachi, I., Giovannucci, E., Glasser, D. B., & Rimm, E. B. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-3-200308050-00005 · Cited by 832
Feldman, H. A., Johannes, C. B., Derby, C. A., Kleinman, K. P., Mohr, B. A., Araujo, A. B., & McKinlay, J. B. (2000) · Preventive Medicine · doi:10.1006/pmed.2000.0643 · Cited by 748
Biomarkers of Endothelial Dysfunction and Risk of Type 2 Diabetes Mellitus
Meigs, J. B. (2004) · JAMA · doi:10.1001/jama.291.16.1978 · Cited by 643
Montorsi, F., Briganti, A., Salonia, A., Rigatti, P., Margonato, A., Macchi, A., Galli, S., Ravagnani, P. M., & Montorsi, P. (2003) · European Urology · doi:10.1016/s0302-2838(03)00305-1 · Cited by 597
Rosen, R. C., Fisher, W. A., Eardley, I., Niederberger, C., Nadel, A., & Sand, M. (2004) · Current Medical Research and Opinion · doi:10.1185/030079904125003467 · Cited by 588
Self-citationUse of Sildenafil (Viagra) in Patients With Cardiovascular Disease
Cheitlin, M. D., Hutter, A. M., Brindis, R. G., Ganz, P., Kaul, S., Russell, R. O., Zusman, R. M., Forrester, J. S., Douglas, P. S., Faxon, D. P., et al. (1999) · Circulation · doi:10.1161/01.cir.99.1.168 · Cited by 497
Use of sildenafil (Viagra) in patients with cardiovascular disease
Cheitlin, M. D., Hutter, A. M., Brindis, R. G., Ganz, P., Kaul, S., Russell, R. O., Zusman, R. M., Forrester, J. S., Douglas, P. S., Faxon, D. P., et al. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00656-1 · Cited by 449
Research works printed but not linked: 2
- Pritzker, 1999, The penile stress test: A window to the heart of the man [abstract]?, Circulation, 100, 3751
- Nicolosi, 2003, Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: A population study, Int J Impot Res, 15, 253, 10.1038/sj.ijir.3901010 · DOI
Cited by
Sorted by citations
Items 301–327 of 327
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Shah, R., Patel, K. H., & Moochhala, S. (2020) · PARIPEX-INDIAN JOURNAL OF RESEARCH · doi:10.36106/paripex/8001467
A interação: Disfunção Eréctil e Doença Cardiovascular
Mendes, N. M. P. O. (2014) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/nws4-xw76
Psikolojik Yönleriyle Erektil Disfonksiyon: Nedenler - Belirtiler - Çözümler
Demirel, Y. (2021) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.6
Esterbauer, B., & Jungwirth, A. (2009) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-009-0719-z
Leiber, C. (2014) · Springer eBooks · doi:10.1007/978-3-642-41168-7_49-1
NHG-Standaard Erectiele disfunctie
Leusink, P., Boer, L. D., Vliet, V. C., Rambharose, V., Sprengers, A., Mogendorff, S., Rijn-Van, V., & Kortenhof, N. (2011) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-313-8279-8_79
Rokach, A., & Patel, K. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819174-3.00008-5
Is erectile dysfunction a marker for coronary heart disease?
(2008) · Trends in Urology Gynaecology & Sexual Health · doi:10.1002/tre.79
Jackson, G. (2007) · The Journal of Urology · doi:10.1016/j.juro.2007.08.096
Self-citationLeiber, C. (2016) · Springer eBooks · doi:10.1007/978-3-642-39940-4_49
Erectile Dysfunction: Identification, Assessment, Treatment, and Follow-Up
Jensen, P. K., & Albaugh, J. A. (2020) · Springer eBooks · doi:10.1007/978-3-030-45267-4_4
Jackson, G. (2009) · doi:10.1093/med/9780199566990.003.1503
Self-citationh Maxi-K Gene Transfer in Males with Erectile Dysfunction: Results of the First Human Trial
Melman, A., Bar-Chama, N. C., McCullough, A., Davies, K. P., & Christ, G. J. (2006) · Human Gene Therapy · doi:10.1089/hum.2006.17.ft-266
h Maxi-K Gene Transfer in Males with Erectile Dysfunction: Results of the First Human Trial
Melman, A., Bar-Chama, N. C., McCullough, A., Davies, K. P., & Christ, G. J. (2006) · Human Gene Therapy · doi:10.1089/hum.2006.17.ft-269
Erectile dysfunction as a marker of cardiovascular risk in men
(2006) · Independent Nurse · doi:10.12968/indn.2006.1.10.74342
Waldkirch, E. S., Becker, A. J., & Stief, C. G. (2014) · Springer eBooks · doi:10.1007/978-3-662-45739-9_52
Galiano, M. (2011) · EMC - Traité de médecine AKOS · doi:10.1016/s1634-6939(11)49358-3
Jackson, G. (2007) · CRC Press eBooks · doi:10.3109/9780203463048-44
Self-citationNovel Method for Identifying and Treating Erectile Dysfunction
Gupta, R. A., & Shiven, A. (2023) · International Journal of Life Science and Pharma Research · doi:10.22376/ijlpr.2023.13.6.p234-p252
Hilz, M. J., Wang, R., & Vodušek, D. B. (2023) · Springer eBooks · doi:10.1007/978-3-031-43036-7_14
What Affects Male Sexual Activity: A Comprehensive Review
Peng, J., Xiang, B., Yang, J. Y., Tang, Y., Li, D., & Tang, Z. (2023) · Health · doi:10.4236/health.2023.1512089 · Cited by 1
Jäger, T. (2024) · Springer eBooks · doi:10.1007/978-3-662-68405-4_3
Vasculogenic and Postoperative Neurogenic Impotence
Fode, M., Sønksen, J., Quallich, S. A., & Ohl, D. A. (2013) · Research at the University of Copenhagen (University of Copenhagen)
Tissot, G., & Galiano, M. (2025) · EMC - Tratado de Medicina · doi:10.1016/s1636-5410(25)50383-5
Tissot, G., & Galiano, M. (2025) · EMC - AKOS - Trattato di Medicina · doi:10.1016/s1634-7358(25)50544-2
Cardiovascular Issues in the Treatment of Erectile Dysfunction
Jackson, G. (2010) · Humana Press eBooks · doi:10.1007/978-1-60327-536-1_13
Self-citationRole of Oxidative Stress in ED: Unraveling the Molecular Mechanism
Musicki, B., & Burnett, A. L. “. (2012) · Humana Press eBooks · doi:10.1007/978-1-61779-776-7_28
Metadata
- 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
- 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
- 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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