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…
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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
Solomon, H., Man, J. W., & Jackson, G. (2003) · Heart · doi:10.1136/heart.89.3.251 · Cited by 436
Self-citationSHABSIGH, R., KAUFMAN, J. M., STEIDLE, C., & PADMA-NATHAN, H. (2004) · Journal of Urology · doi:10.1097/01.ju.0000132389.97804.d7 · Cited by 406
DeBusk, R. F., Drory, Y., Goldstein, I., Jackson, G., Kaul, S., Kimmel, S. E., Kostis, J. B., Kloner, R. A., Lakin, M. M., Meston, C. M., et al. (2000) · The American Journal of Cardiology · doi:10.1016/s0002-9149(00)00896-1 · Cited by 387
Self-citationIs Erectile Dysfunction the “Tip of the Iceberg” of a Systemic Vascular Disorder?
Montorsi, P., Montorsi, F., & Schulman, C. C. (2003) · European Urology · doi:10.1016/s0302-2838(03)00307-5 · Cited by 338
Sexual Dysfunction and Cardiac Risk: The Second Princeton Consensus Conference
Kostis, J. B., Jackson, G., Rosen, R., Barrett-Connor, E. L., Billups, K. L., Burnett, A. L. “., CARSONIII, C., CHEITLIN, M., DeBusk, R. F., & Fonseca, V. A. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.11.008 · Cited by 327
Self-citationHemodynamic Effects of Sildenafil in Men with Severe Coronary Artery Disease
Herrmann, H. C., Chang, G., Klugherz, B. D., & Mahoney, P. D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200006013422201 · Cited by 298
Katz, S. D., Balidemaj, K., Homma, S., Wu, H., Wang, J., & Maybaum, S. W. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00790-7 · Cited by 295
Does severity of ischemic coronary disease correlate with erectile function?
Greenstein, A., Chen, J., Miller, H. I., Matzkin, H., Villa, Y., & BRAF, Z. F. (1997) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3900282 · Cited by 292
The effect of sildenafil on human vascular function, platelet activation, and myocardial ischemia
Halcox, J., Nour, K. R. A., Zalos, G., Mincemoyer, R., Waclawiw, M. A., Rivera, C. E., Willie, G., Ellahham, S. H., & Quyyumi, A. A. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02139-3 · Cited by 274
Correlates for Erectile and Ejaculatory Dysfunction in Older Dutch Men: A Community‐Based Study
Blanker, M. H., Bohnen, A. M., Groeneveld, F. P. M. J., Bernsen, R. M. D., Prins, A., Thomas, S., & Bosch, J. L. H. R. (2001) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2001.49088.x · Cited by 260
Sexual Dysfunction and Cardiac Risk (the Second Princeton Consensus Conference)
Kostis, J. B., Jackson, G., Rosen, R. C., Barrett-Connor, E. L., Billups, K. L., Burnett, A. L. “., Carson, C. C., Cheitlin, M. D., DeBusk, R. F., Fonseca, V. A., et al. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.03.065 · Cited by 250
Self-citationHolden, C. A., McLachlan, R. I., Pitts, M. K., Cumming, R. G., Wittert, G., Agius, P. A., Handelsman, D. J., & de Kretser, D. M. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66911-5 · Cited by 238
Blanker, M. H., Bosch, J. L. H. R., Groeneveld, F. P. M. J., Bohnen, A. M., Prins, A., Thomas, S., & Hop, W. C. J. (2001) · Urology · doi:10.1016/s0090-4295(00)01091-8 · Cited by 236
Relation of erectile dysfunction to angiographic coronary artery disease
Solomon, H., Man, J. W., Wierzbicki, A. S., & Jackson, G. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(02)03113-2 · Cited by 222
Self-citationEndogenous Sex Hormones and Cardiovascular Disease in Men
Muller, M., van der Schouw, Y. T., Thijssen, J. H. H., & Grobbee, D. E. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-030611 · Cited by 210
Desouza, C. V., Parulkar, A., Lumpkin, D., Akers, D. L., & Fonseca, V. A. (2002) · Diabetes Care · doi:10.2337/diacare.25.8.1336 · Cited by 204
Obesity, the metabolic syndrome, and sexual dysfunction
Esposito, K., & Giugliano, D. (2005) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3901333 · Cited by 196
HEMODYNAMIC EFFECTS OF SILDENAFIL IN MEN WITH SEVERE CORONARY ARTERY DISEASE
Errmann, C. H., Hang, G. E. C., Lugherz, D. K., & Ahoney, P. A. D. M. (2000) · Cited by 194
Effect of sildenafil in patients with erectile dysfunction taking antihypertensive therapy
Kloner, R. A. (2001) · American Journal of Hypertension · doi:10.1016/s0895-7061(00)01177-8 · Cited by 177
Self-citationTime course of the interaction between tadalafil and nitrates
Kloner, R. A., Hutter, A. M., Emmick, J. T., Mitchell, M. I., Denne, J. S., & Jackson, G. (2003) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.09.023 · Cited by 165
Self-citationIS ERECTILE DYSFUNCTION A MARKER FOR CARDIOVASCULAR DISEASE?
Kirby, M. G., Jackson, G., Betteridge, J. D., & Friedli, K. (2001) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2001.tb11141.x · Cited by 161
Self-citationKloner, R. A., Jackson, G., Emmick, J. T., Mitchell, M. I., Bedding, A. W., Warner, M. R., & PEREIRA, A. (2004) · The Journal of Urology · doi:10.1097/01.ju.0000142687.75577.e4 · Cited by 154
Self-citationThadani, U., Smith, W., Nash, S., Bittar, N., Glasser, S. P., Narayan, P., Stein, R. A., Larkin, S., Mazzu, A. L., Tota, R. R., et al. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02563-9 · Cited by 144
Endothelial dysfunction links erectile dysfunction to heart disease
Kirby, M., Jackson, G., & Simonsen, U. (2005) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2005.00453.x · Cited by 142
Self-citationNicolosi, A., Glasser, D., Moreira, E. D., Villa, M., & for the Erectile Dysfunction Epidemiology Cross National Study Group (2003) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3901010 · Cited by 131
Cardiovascular effects of tadalafil in patients on common antihypertensive therapies
Kloner, R. A., Mitchell, M., & Emmick, J. T. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00075-4 · Cited by 100
Self-citationPast, present, and future: a 7-year update of Viagra® (sildenafil citrate)
Jackson, G., Gillies, H., & Osterloh, I. H. (2005) · International Journal of Clinical Practice · doi:10.1111/j.1368-5031.2005.00578.x · Cited by 98
Self-citationZusman, R. M., Prisant, L. M., & Brown, M. J. (2000) · Journal of Hypertension · doi:10.1097/00004872-200018120-00022 · Cited by 96
Effect of sildenafil on blood pressure and arterial wave reflection in treated hypertensive men
Mahmud, A., Hennessy, M., & Feely, J. (2001) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001244 · Cited by 86
Gillies, H., Roblin, D., & Jackson, G. (2002) · International Journal of Cardiology · doi:10.1016/s0167-5273(02)00421-7 · Cited by 79
Self-citationFox, K. (2003) · European Heart Journal · doi:10.1016/j.ehj.2003.09.021 · Cited by 76
Evaluation of Acute Risk for Myocardial Infarction in Men Treated With Sildenafil Citrate
Mittleman, M. A., Maclure, M., & Glasser, D. B. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.03.097 · Cited by 65
ERECTILE DYSFUNCTION: CARDIOVASCULAR RISK AND THE ROLE OF THE CARDIOLOGIST
Solomon, H., Man, J., Wierzbicki, A. S., O’Brien, T., & Jackson, G. (2003) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2003.tb10434.x · Cited by 64
Self-citationJackson, G., Kloner, R. A., Costigan, T. M., Warner, M. R., & Emmick, J. T. (2004) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2004.04024.x · Cited by 50
Self-citationSexual Activity in Patients With Angina
DeBusk, R. F. (2003) · JAMA · doi:10.1001/jama.290.23.3129 · Cited by 38
Potential Role of Type 5 Phosphodiesterase Inhibition in the Treatment of Congestive Heart Failure
Katz, S. D. (2003) · Congestive Heart Failure · doi:10.1111/j.1527-5299.2002.00288.x · Cited by 36
SILDENAFIL FOR PRIMARY PULMONARY HYPERTENSION: SHORT AND LONG‐TERM SYMPTOMATIC BENEFIT
Jackson, G., & Chambers, J. B. (2002) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2002.tb11281.x · Cited by 28
Self-citationPadma-Nathan, H. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(02)02393-2 · Cited by 25
Mancia, G. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(02)02413-5 · Cited by 17
Porst, H., Padma-Nathan, H., Thibonnier, M., & Ian Eardley, C. (2002) · European Urology Supplements · doi:10.1016/s1569-9056(02)80592-9 · Cited by 14
Pickering, T. G. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(02)02415-9 · Cited by 11
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
Corona, G., Lee, D. M., Forti, G., O'Connor, D. B., Maggi, M., O’Neill, T. W., Pendleton, N., Bártfai, G., Boonen, S., Casanueva, F. F., et al. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01601.x · Cited by 554
Erectile Dysfunction and Risk of Cardiovascular Disease
Dong, J.-Y., Zhang, Y., & Qin, L.-Q. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.06.024 · Cited by 453
A Population-Based, Longitudinal Study of Erectile Dysfunction and Future Coronary Artery Disease
Inman, B. A., Sauver, J. L. S., Jacobson, D. J., McGree, M. E., Nehra, A. X., Lieber, M. M., Roger, V. L., & Jacobsen, S. J. (2009) · Mayo Clinic Proceedings · doi:10.4065/84.2.108 · Cited by 422
Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction
Andersson, K. (2011) · Pharmacological Reviews · doi:10.1124/pr.111.004515 · Cited by 405
McCabe, M. P., Sharlip, I. D., Lewis, R., Atalla, E., Balon, R., Fisher, A. D., Laumann, E. O., Lee, S. W., & Segraves, R. T. (2016) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2015.12.015 · Cited by 337
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
