Erectile dysfunction, sildenafil and cardiovascular risk

Cardiovascular risk factors are commonly associated with erectile dysfuncti on and should be identified and treated. Patients with cardiovascular diseases should be assessed and counselled reg arding their fitness for sexual activity. The danger of concurrent use of sildenafil and nitrates under any circumsta nces, regardless of age and sex, must be highlighted at all levels of the c ommunity. Sildenafil is absolutely contraindicated in patients receiving treatment wi th long-acting nitrates for ischaemic heart disease. Patients who need sublingual short-acting nitrates infrequently should not be precluded from taking sildenafil, provided they are aware that sildenafi l is not to be taken within 24 h of taking the nitrate.