Requests by older men to obtain medications for erectile dysfunction present a good opportunity for a review of their general health. GPs are aware ofo the need to consider underlying medical conditions when assessing men who have erectile dysfunction. This is particularly important, as if sildenafil and tadalafil are taken within twenty-four hours of nitrates, severe hypotension may result. This becomes particularly relevant if the man were to goo on to ave an acute coronary event requiring treatment with nitrates.
As a result of this potential interaction, when older men present with erectile dysfunction, their risk factors for cardiovascular disease should be assessed. These include serum lipids and blood glucose level, blood pressure, family history and personal history of cardiovascular disease. Some men with erectile dysfunction may also consume large amounts of alcohol and this provides an opportunity to counsel them about this.