From bedroom to boardroom: erectile dysfunction as a window into cardiovascular health

Andres H. Guillen Lozoya, Milad Bonakdarhashemi, Sevann Helo, Matthew Ziegelmann, Tobias Kohler^*
Urology Department, Mayo Clinic, Rochester, MN, USA
* Corresponding Author: Tobias Kohler. Email: email
(This article belongs to the Special Issue: Advancements in Men's Health: The Latest in Andrology, Male Infertility, and Sexual Medicine)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.075775

Received 08 November 2025; Accepted 22 February 2026; Published online 24 March 2026

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Abstract

Erectile dysfunction (ED) has evolved from a quality-of-life concern to a recognized marker of systemic vascular disease and an early harbinger of cardiovascular events. The Princeton IV Consensus underscores that men presenting with erectile dysfunction should be presumed at increased cardiovascular risk until proven otherwise, advocating integrated risk stratification and lifestyle optimization. Beyond established risk scores, advances in omics, vascular imaging, and digital health promise precision tools for early detection and prevention. This review aims to examine erectile dysfunction as an early marker of cardiovascular disease and to summarize current and emerging approaches to cardiovascular risk stratification in men with ED.