Investigation of the Effect of the Atherogenic Index on the Therapeutic Response to Tadalafil in Patients With Vascular Erectile Dysfunction

Inclusion Criteria:Men older than 40 years of age who have been diagnosed with vascular erectile dysfunction, have had symptoms for at least three months, have been considered suitable for tadalafil treatment, and have received tadalafil therapy for at least four weeks. \- Exclusion Criteria:Use of nitrates Uncontrolled cardiac arrhythmias Hypotension Diagnosis of hypogonadism History of major cardiovascular events within the last 6 months (including uncontrolled hypertension or severe ischemic heart disease) Severe hepatic or renal insufficiency Patients receiving hormone replacement therapy Patients diagnosed with psychogenic, neurological, hormonal, or pharmacological erectile dysfunction History of radical pelvic surgery Anatomical abnormalities of the penis History of non-arteritic anterior ischemic optic neuropathy (NAION) Retinitis pigmentosa Known hypersensitivity to tadalafil or other phosphodiesterase type-5 inhibitors Alcohol or substance abuse Use of other treatments for erectile dysfunction Unstable diabetes mellitus History of medications affecting lipid profile (such as corticosteroids or certain antidepressants) Initiation or dose modification of lipid-lowering therapy (e.g., statins, fibrates) within the last 3 months Uncontrolled thyroid dysfunction Active infection or inflammatory conditions Patients receiving active cancer treatment Inability to comply with study procedures Beck Depression Inventory score greater than 0 \-