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Conclusion ED prevalence differs across subsets of patients with CAD and is related to coronary clinical presentation and extent of CAD. In patients with established CAD, ED comes before CAD in the majority by an average of 2 up to 3 years. Methods and Resultsó We evaluated the prevalence of ED in 133 uncomplicated diabetic men with angiographically verified silent CAD and in 127 diabetic men without myocardial ischemia at exercise ECG, 48-hour ambulatory ECG, and stress echocardiography. The groups were comparable for age and diabetes duration. Patients were screened for ED using the validated International Index of Erectile Function (IIEF-5) questionnaire. The prevalence of ED was significantly higher in patients with than in those without silent CAD (33.8% versus 4.7%; P=0.000). Multiple logistic regression analysis showed that ED, apolipoprotein(a) polymorphism, smoking, microalbuminuria, HDL, and LDL were significantly associated with silent CAD; among these risk factors, ED appeared to be the most efficient predictor of silent CAD (OR, 14.8; 95% CI, 3.8 to 56.9). Low-dose once-daily use: 2.5 mg PO qd, without regard to timing of sexual activity; may increase to 5 mg/d based on efficacy and tolerability What you need to know about Cialis, Levitra, and Viagra. viagra generic for sale How long have you had difficulty with erections? The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family's medical history as well as your own medical history and current health, your doctor may treat you with oral medications such as Viagra or similar drugs. If this fails, he or she may refer you to a urologist or psychologist. When to Contact a Medical Professional During the period following the licensing of sildenafil for use in ED, an increase in the number of patients seeking treatment for heretofore-untreated ED was widely anticipated. This institution did not find an increase in the number of men referred with ED in the year following 14 September 1998, compared to the year preceding this date. It is not clear though, if this anticipated increase in the number of men with ED have been dealt with in the primary care. Considering that the referral pattern from primary to secondary care has not changed in this institution, we do not feel that this has happened. You may be relieved to learn that the risk of breast cancer from taking the birth control pill is very small, as revealed in research from the Mayo Clinic. However, there are many other side effects associated with the pill and the birth control patch. Learn more about these risks so you can make better contraceptive choices and protect your health. The manufacturer has warned emergency physicians of this dangerous side effect in an effort to avoid the possibility of giving nitroglycerin to a patient with chest pain who presents to the emergency department after taking sildenafil. Paramedics across the country have also been cautioned to ask men with chest pain if sildenafil has been taken before they administer sublingual nitroglycerin. Recreational drugs such as amyl nitrite ("poppers") are thought to have the same hypotensive effect when combined with sildenafil. A study presented at the same AUA meeting found that unpadded seats reduce penile blood flow more than padded seats. The width of the padded seats wasn't a factor. One way to improve erectile dysfunction is to make some simple lifestyle changes. For some men, adopting a healthier lifestyle, such as quitting smoking, exercising regularly, and reducing stress, may be all that is needed to find relief. For those who require more intensive treatment, adopting these lifestyle changes in addition to other treatments can further help. Have there been any recent changes in your life? These medications work when there is sexual stimulation. Depending on the treatment, it will need to be taken 20 minutes to 1 hour before sex and the period of time over which it works can vary between 3 hours and up to 36 hours. TUESDAY, April 14 (HealthDay News) -- The erectile dysfunction drugs Cialis (tadalafil) and Viagra (sildenafil) didn't appear to damage vision in men who took the medications daily for six months, according to a drug company study. Erectile Dysfunction: Diagnosing Erectile Dysfunction All of these conditions or lifestyle factors contribute to erectile difficulties in three major ways: By reducing blood flow, causing nerve damage, or changing the hormonal environment. real viagra