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A natural phosphodiesterase 5 inhibitor would be nice.  This study looked at a lot of traditional herbal remedies to block phosphodiesterase 5 activity.  Only Epimedii herb with the active ingredient icariin worked.  Other preparations were shown to work, but via different mechanisms.  This is a review of studies looking at these herbal preparations.

elevated insulin in insulin resistance decreases circulating Natriuretic peptide.  This provides a direct link between obesity and cardiovascular disease

Cell culture study finds that 5alpha-reductase inhibition decreased 5alpha-pregnanes and thus inhibited cell proliferation and detachment; this is in contrast to the 4 pregnenes that occur through the enzymes 3alpha-hydroxysteroid oxidoreductase and the 20alpha-hydroxysteroid oxidoreductase, which show anti cell proliferation and cell detachment.