It has been demonstrated in a series of studies that erectile dysfunction (ED) appears to be one of risk factors and predictors of ischemic heart disease (IHD). According to the SSRC PM data in a cohort of 300 men with high cardiovascular risk ED was diagnosed in 61% of cases, while among 300 men with verified diagnosis of IHD was detected in 92.7% of cases. According to recommendations of the European Society of Urology changes of life style and correction of risk factors should precede therapy of ED or be components of complex therapy. It is known that some antihypertensive drugs (nonselective beta-adrenoblockers, thiazide diuretics) can negatively affect erectile function. According to data of comparative randomized clinical study average therapeutic doses of thiazide-like and thiazide diuretics in combination with ACE inhibitors do not worsen erectile function. Data on effect of lipid lowering therapy on erectile function are equivocal. Type 5 phosphodiesterase inhibitors (PDI) are first line preparations for the treatment of patients with ED. Safety of combination of type 5 PDI with main groups of antihypertensive drugs has been demonstrated in persons with risk factors of CVD and ED. The use of type 5 PDI in men depends on degree of compensation of cardiovascular system. In unstable cardiovascular events preparations of this group can be also carefully used. Simultaneous administration of nitrates is a contraindication for type 5 PDI.