A recent study published in the journal Circulation found patients with erectile dysfunction (ED) who were treated with telmisartan, ramipril, or both were at greater risk for cardiovascular events than other patients on the same medications. "The present data clearly show that ED is closely associated with an increased risk for all-cause deaths, as well as the primary composite outcome of cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure," wrote Michael Böhm, MD, of the University of the Saarland, Saarbrücken, Germany, and colleagues. For the study, the researchers looked at a subgroup of 1,549 men who had participated in either the ONTARGET study, which looked at the effectiveness of a ramipril/telmisartan combination in patients with cardiovascular disease, or the TRANSCEND sudy, which examined the effects of telmisartan in patients who were intolerant of ACE inhibitors. Of those enrolled in the ONTARGET study, 400 had been randomly assigned to ramipril, 395 to telmisartan, and 381 to combination therapy. Among those in teh TRANSCEND study, 202 patients had been randomized to placebo and 171 to telmisartan. Of the 1,519 men included in the final analysis, 842 had moderate to severe ED at baseline and 677 had mild ED or functioned normally.