PASADENA, Calif.--(BUSINESS WIRE)--25 years after Viagra hit the market, a group of experts from across the country examined the link between erectile dysfunction (ED) and heart health. Their summary and guidelines have now been published in the Journal of Sexual Medicine. They determined that PDE-5 inhibitors are still safe for the cardiovascular system..

加州帕萨迪纳（商业新闻短讯）——伟哥上市25年后，来自全国各地的一组专家研究了勃起功能障碍（ED）与心脏健康之间的联系。他们的总结和指南现已发表在《性医学杂志》上。他们确定PDE-5抑制剂对心血管系统仍然安全。。

In March of 2023, a group of 17 interdisciplinary scientists and practitioners convened “The Princeton IV: PDE-5 Inhibitors and Cardiac Health Symposium” held at Huntington Medical Research Institutes (HMRI) in Pasadena, California. Principal Investigator Robert A. Kloner, MD, PhD, Chief Science Officer and Scientific Director of Cardiovascular Research at HMRI, and Professor of Medicine at the Keck School of Medicine of the University of Southern California, led the group with co-chair Raymond Rosen, PhD of the University of California San Francisco, steering committee members Arthur L.

2023年3月，由17名跨学科科学家和从业者组成的小组在加利福尼亚州帕萨迪纳的亨廷顿医学研究所（HMRI）召开了“普林斯顿IV：PDE-5抑制剂与心脏健康研讨会”。首席研究员Robert A.Kloner，医学博士，博士，HMRI首席科学官兼心血管研究科学总监，南加州大学凯克医学院医学教授，与联合主席Raymond Rosen，加州大学旧金山分校博士，指导委员会成员Arthur L。

Burnett, MD, MBA of Johns Hopkins, and Martin M. Miner, MD of Brown University. The conference was funded by an unrestricted grant from Sanofi to readdress the cardiovascular workup of men presenting with ED and the cardiovascular safety of the phosphodiesterase-5 (PDE-5) inhibitors for treating ED..

约翰·霍普金斯大学（Johns Hopkins）MBA博士伯内特（Burnett）和布朗大学（Brown University）医学博士马丁·米纳（Martin M.Miner）。该会议由赛诺菲（Sanofi）的无限制拨款资助，以重新审视ED患者的心血管检查以及用于治疗ED的磷酸二酯酶-5（PDE-5）抑制剂的心血管安全性。。

Princeton IV expanded on the findings of Princeton III, held over a decade ago. These findings include:

普林斯顿四世扩大了十多年前举行的普林斯顿三世的研究结果。这些发现包括：

1. ED is a risk-marker and risk-enhancer for atherosclerotic cardiovascular disease (CVD), and men who present with ED, especially vasculogenic ED, should have an assessment of their atherosclerotic cardiovascular risk as outlined by the American College of Cardiology/American Heart Association algorithms..

ED是动脉粥样硬化性心血管疾病（CVD）的风险标志物和风险增强剂，患有ED的男性，尤其是血管性ED，应该按照美国心脏病学会/美国心脏协会算法的概述，对其动脉粥样硬化性心血管风险进行评估。。

2. Those patients at the borderline to intermediate risk for cardiovascular events should undergo coronary artery calcium (CAC) scoring by computerized tomography scanning. The CAC score will aid in determining therapy and the need to refer to a cardiologist.

那些处于心血管事件临界至中等风险的患者应通过计算机断层扫描进行冠状动脉钙（CAC）评分。CAC评分将有助于确定治疗方法以及是否需要咨询心脏病专家。

3. Patients with ED should be characterized as low-risk, intermediate (or indeterminable), or high-risk of developing a cardiac event with sexual activity. Risk is largely assessed by the patient’s exercise ability for age and may require a stress test.

ED患者的特征应为低风险，中等（或不确定）或高风险发生有性行为的心脏事件。风险主要由患者的年龄运动能力来评估，可能需要进行压力测试。

4. If the patient has good exercise tolerance without symptoms or signs of ischemia (lack of oxygen) and is classified as low-risk, then ED can be treated.

如果患者具有良好的运动耐量，没有缺血（缺氧）的症状或体征，并且被归类为低风险，则可以治疗ED。

5. If a patient is on nitrates or riociguat then PDE-5 inhibitors are contraindicated. However, in some cases, if nitrates are not necessary, then consideration should be given to stopping them and trying PDE5 inhibitors to treat ED.

如果患者服用硝酸盐或riociguat，则禁用PDE-5抑制剂。然而，在某些情况下，如果不需要硝酸盐，则应考虑停止它们并尝试使用PDE5抑制剂治疗ED。

6. New observational data show an association between the use of PDE-5 inhibitors in men with ED and lower rates of major adverse cardiovascular events and overall mortality. Prospective trials are needed.

新的观察数据显示，ED患者使用PDE-5抑制剂与主要不良心血管事件发生率和总体死亡率降低之间存在关联。需要进行前瞻性试验。

7. Recent studies show that dietary supplements for treating ED may be adulterated with PDE-5 inhibitors such as Viagra. The problem is that some men on nitrates may inadvertently receive PDE-5 inhibitors (a current contra-indication due to hypotension [low blood pressure] when both drugs are taken together)..

最近的研究表明，用于治疗ED的膳食补充剂可能掺有PDE-5抑制剂，如伟哥。问题是，一些服用硝酸盐的男性可能会无意中接受PDE-5抑制剂（目前由于两种药物合用而导致低血压[低血压]的禁忌症）。。

8. Some countries are now making PDE-5 inhibitors available over the counter with input from pharmacists. There is growing interest in similar possibilities in the U.S., but this remains under study.

一些国家现在正在药剂师的投入下，在柜台上提供PDE-5抑制剂。在美国，人们对类似的可能性越来越感兴趣，但这仍在研究中。

9. PDE-5 inhibitors also appear to have cardiovascular safety in women. They are used for treating pulmonary hypertension in women. Subgroups of women with female sexual dysfunction may benefit from PDE-5 inhibitors, but more research is required. New therapies have been developed to treat female sexual dysfunction..

PDE-5抑制剂在女性中似乎也具有心血管安全性。它们用于治疗女性肺动脉高压。患有女性性功能障碍的女性亚组可能会受益于PDE-5抑制剂，但需要更多的研究。已经开发出治疗女性性功能障碍的新疗法。。

“Cardiovascular disease (CVD) remains a leading cause of death in the world. The development of ED is often a precursor to the development of atherosclerotic coronary artery disease,” said Kloner. “When a man presents with ED, leading to a CVD workup, there is an opportunity for earlier identification and treatment of risk factors for CVD, which may ultimately save lives.”.

克洛纳说：“心血管疾病（CVD）仍然是世界上主要的死亡原因。ED的发展通常是动脉粥样硬化性冠状动脉疾病发展的前兆。”。“当一名男性出现ED，导致心血管疾病检查时，有机会尽早识别和治疗心血管疾病的危险因素，最终可能挽救生命。”。

The most important future studies include prospective, randomized, placebo-controlled studies to see if drugs like tadalafil and sildenafil reduce major adverse cardiovascular events. There are ongoing studies of regenerative medicine to study their effects on ED. While still considered investigational, shock wave therapy, stem cells and platelet-rich plasma may hold promise..

未来最重要的研究包括前瞻性、随机、安慰剂对照研究，以观察他达拉非和西地那非等药物是否能减少主要不良心血管事件。目前正在进行再生医学研究，以研究其对ED的影响。虽然仍被认为是研究性的，但冲击波疗法，干细胞和富含血小板的血浆可能具有前景。。

The full manuscript can be read here.

完整的手稿可以在这里阅读。

About HMRI

关于HMRI

Huntington Medical Research Institutes (HMRI) is a pioneer in scientific research with a 70-year track record of groundbreaking discoveries that have changed our world. Today, our work is laser-focused on innovative biomedical research that investigates diseases of the heart and brain, and we are committed to inspiring and educating the next generation of scientists.

亨廷顿医学研究所（HMRI）是科学研究的先驱，拥有70年的开创性发现记录，这些发现改变了我们的世界。今天，我们的工作是激光专注于研究心脏和大脑疾病的创新生物医学研究，我们致力于激励和教育下一代科学家。

Our scientists work on solving Alzheimer’s disease, mental illnesses like schizophrenia, and cardiovascular disease. At HMRI, we serve society by fearlessly pursuing science and contributing to a future free from diseases that today affect millions of people around the world. For more information about HMRI, visit https://www.hmri.org..

我们的科学家致力于解决阿尔茨海默病、精神分裂症等精神疾病和心血管疾病。在HMRI，我们无畏地追求科学，为社会服务，为一个没有当今影响全世界数百万人的疾病的未来做出贡献。有关HMRI的更多信息，请访问https://www.hmri.org..

About the International Society for Sexual Medicine (ISSM)

关于国际性医学学会（ISSM）

The International Society for Sexual Medicine was established in 1978. The goals of the ISSM are to encourage the highest standards of practice, education, and research in the field of human sexuality; to develop and assist in developing scientific methods for the diagnosis, prevention, and treatment of conditions affecting human sexual function; and to promote the publication and encourage contributions to the medical and scientific literature in the field of sexual function.

国际性医学学会成立于1978年。ISSM的目标是鼓励人类性行为领域的实践、教育和研究达到最高标准；开发并协助开发诊断、预防和治疗影响人类性功能疾病的科学方法；并促进出版，鼓励对性功能领域的医学和科学文献做出贡献。

The ISSM has over 3,000 members from all five continents and from 100+ nations. For more information about the ISSM, visit https://www.issm.info..

ISSM拥有来自五大洲和100多个国家的3000多名成员。有关ISSM的更多信息，请访问https://www.issm.info..