Erectile dysfunction: the earliest sign of generalized vascular disease?**Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology

Until sildenafil, the first effective oral agent for erectile dysfunction (ED), was introduced, only genitourinary physicians concerned themselves with this problem. Certainly cardiologists rarely asked their patients with cardiovascular disease about difficulty developing or maintaining a penile