The Cardiovascular Risk is the probability of an individual developing fatal or non-fatal atherosclerotic cardiovascular event over a given time period. This is the result of the combined effect of several Cardiovascular Risk Factors that may or may not be modifiable.
El estudio de los factores de riesgo cardiovascular consta de una buena anamnesis, una exploración física y un estudio con determinadas pruebas diagnósticas complementarias. De esta forma podremos realizar un diagnóstico preciso y establecer un plan terapéutico para prevenir un evento cardiovascular.
Las pruebas diagnósticas más frecuentemente utilizadas en el estudio de los factores de riesgo cardiovascular son un análisis de sangre completo, un electrocardiograma, ecografía Doppler de la arteria carótica cervical y Holter de Presión Arterial (MAPA) 24h.
Recently there has been an increase in some of the Cardiovascular Risk Factors (CRF), such as obesity and diabetes.
The event is caused by the accumulation of fatty deposits inside the arteries lumen, known as arteriosclerosis. This, in association with other cardiovascular risk factors named above, increases the risk of heart and vascular disease, either in cerebral vessels or in other peripheral areas.
Population studies have demonstrated that elevated levels of LDL cholesterol (Low Density Lipoprotein) and other apolipoproteins, are directly associated with the risk of having an atherosclerotic cardiovascular event (ASCVE).
The study of cardiovascular risk factors requires a complete medical history, a physical examination and a study with some specific tests. With this information we will achieve an accurate diagnosis and establish a therapeutic plan for preventing a cardiovascular event.
The diagnostic tests in the study of cardiovascular risk factors most frequently used are:
A normal erectile function requires the coordination of vascular, neurological, cavernous, hormonal and psychological factors. The alteration of any of these factors could cause erectile dysfunction.
Traditionally, the causes of erectile dysfunction have been classified as organic, psychological or mixed.
Nowadays we know that 80% of the cases correspond to organic causes.
The main organic-based causes of erectile dysfunction are those represented in Table 1 (Fernández Rodríguez et al).
Diabetes mellitus produces autonomic arteriopathy and neuropathy that can cause erectile dysfunction at young ages (35-50% of men with diabetes suffer erectile dysfunction).
High blood pressure can also cause erectile dysfunction due to the arterial disease that it causes.
Hyperlipidemia produces an accumulation of cholesterol in the arteries that leads to peripheral artery disease, favoring the appearance of erectile dysfunction.
Unhealthy habits such as smoking, obesity and lack of exercise can contribute to erectile dysfunction by affecting blood flow.
Therefore, erectile dysfunction can be a marker of Cardiovascular Risk and could indicate arterial disease in other locations as well. (Fig. 1 and 2). For this reason, it is important to carry out a study for specifically treating all of the cardiovascular risk factors.
As we have explained before, cardiovascular risk is the effect of the combination of the different cardiovascular risk factors, that’s why an integral approach will be necessary.
Depending on the result of the cardiovascular risk study, an individualized therapeutic plan will be established for each patient. This will generally consist on:
Non-pharmacological measures include weight loss, dietary measures, physical activity, and decreased consumption of tobacco and alcohol. It has been seen that weight loss and dietary changes can reduce blood triglyceride levels by up to 70%.
1
If an adequate control of risk factors is not achieved with non-pharmacological measures, administration of specific drugs may be necessary according to the needs of each patient and the risk factor to be treated (antihypertensives, antidiabetics, lipid-lowering medication, etc.).
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