Abstract
Six of the major risk factors for coronary heart disease involve lifestyle practices, often not discerned in primary care. Differing paradigms for preventive care and modification for risk are thereby addressed. Motivational interviewing is one technique of reflective listening and nonjudgmental concern to engage patients in behavioral change. As an example of the rationale for intervention to reduce the risk of coronary artery disease, the Commonwealth Study of 2000 is highlighted, noting the failure of men to address warning signals of cardiovascular disease risk and the relationship of erectile dysfunction in men as a possible sentinel marker for early detection of coronary artery disease. A recent article in Journal of the American Medical Association addressed the relationship of incident erectile dysfunction and presence of cardiovascular disease over an 11-year period in more than 4000 men. Therefore, the penis may be an appropriate barometer to determine cardiovascular health and risk and allow partnering with a clinician to modify risk because it is easily identifiable. This is an example of gender-based risk stratification and education that will be addressed in a series of articles on cardiovascular disease risk.