Room 517-D | French Speaking Podium Session Monday, July 11, 2005 Time: 8:30 AM-10:30 AM |
Personality, Erectile Dysfunction and Cardiovascular Comorbidities: a Non-coincidental Association / Personnalité, dysfonction érectile et comorbidités cardiovasculaires: une association non fortuite.
Bonierbale, Mireille *,1, Consoli, Silla 2, Faix , Antoine 3, 1 University Hospital Ste Marguerite, Marseille cedex 09, cedex, France2 European Georges Pompidou Hospital, AP-HP, Department: Clinical Psychology and Consultation-Liaison Psychiatry, Paris, cedex3 Clinique Beausoleil, Montpellier, France
ABSTRACT- Introduction: Despite the fact that ED (Erectile Disorders) have been generally recognized as one of the sentinel indicators of cardiovascular disease, and many psychological factors are known to play a role in ED, the work done on the psychological factors involved in the risk of cardiovascular disease has made no mention of ED, nor made any attempt to find common denominators. Discussion: The prevalence of ED increases in cases of clinically confirmed cardiovascular pathology, and where the patient presents one or more risk factors for arteriosclerosis. The connection between ED and age could to a large extent be due to this type of co-morbidity. The onset and development of erectile disorder would appear to be significantly affected by endothelial dysfunction, due to deterioration in the capacity of these cells to secrete NO. Similar abnormalities can be observed in patients with high risk factors for cardiovascular disease in terms of their parasympathetic nerve endings. An imbalance in the vago-sympathetic system is also suspected in the onset of erectile disorders of psychogenic origin (performance anxiety, depression or relational or circumstantial stress). Emotional upheavals and cardiovascular risk are also related: a depressive ′′reaction′′ is frequent after myocardial infarction, and plays a major role in cardiovascular prognosis (recurrence of coronary events, cardiovascular mortality). Inversely, depressive moods in patients clinically healthy from a cardiovascular standpoint represent in themselves a risk factor for later development of a coronary pathology. Hyperactivity, or sympathetic hyperreactivity in situations of stress has also been evidenced not only in patients suffering from hypertension or with a cardiovascular family history, but more specifically amongst the most anxious and hostile of such patients, as in patients with a ′ ′type A′′behavioral profile.
Key words: erectile dysfunction, cardiovascular risk factors, endothelial dysfunction, personnality, co-morbidity