Metabolic Syndrome smoking

Lifestyle factors have been associated with ED in both cross-sectional and longitudinal studies. In particular, obesity and sedentary lifestyle are clear-cut risk factors for ED, both in men with comorbid illnesses such as hypertension and diabetes, and especially in men without overt cardiovascular disease (50). Other lifestyle factors, such as smoking and alcohol consumption, have been implicated in some, but not all, studies to date. Intervening on cardiovascular and lifestyle factors may have broader benefits beyond restoration of erectile function. This important concept needs careful consideration, as recent studies have implicated the role of the metabolic syndrome, obesity, insulin resistance, and lack of exercise as independent risk factors for both ED and cardiovascular disease (51,52). 

Any relationship between obesity and stroke is likely to be confounded by the positive association of obesity with hypertension, diabetes, hypercholesterolemia and lack of exercise, and the negative association with smoking and concurrent illness. Nevertheless, stroke is more common in the obese, and abdominal obesity appears to be an independent predictor of stroke (Suk et al. 2003). The constellation of metabolic abnormalities including central obesity, decreased high density lipoprotein, elevated triglycerides, elevated blood pressure and impaired glucose tolerance is known as the metabolic syndrome and is associated with a three-fold increase risk of type 2 diabetes and a two-fold increase in cardiovascular risk (Eckel et al. 2005 Grundy et al. 2005). 

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