Erectile Dysfunction Can Be a Wake-Up Call That You Are at Risk for Heart Disease
Erectile dysfunction may provide a warning sign of significant coronary heart disease researchers from the University of Chicago report in the January 23 issue of the Archives of Internal Medicine. Although recent studies suggest an association between erectile dysfunction and atherosclerotic vascular disease, this is the first study to link ED with abnormal results on cardiac stress testing, including evidence for severe coronary artery blockages and markers of a poor cardiovascular prognosis.
In this study, ED was a stronger predictor of significant coronary heart disease than any of the traditional office-based risk factors, such as family history, cholesterol levels or blood pressure.
Cardiologist and study director Parker Ward, M.D., assistant professor of medicine and director of the cardiology clinic at the University of Chicago states, "The good news is that a decrease in sexual function could provide an additional warning sign for the presence of heart disease."
The study focused on 221 men who had been referred to cardiologists at the University of Chicago for nuclear stress testing, a widely used non-invasive way to detect the extent, severity and reversibility of coronary heart disease. Before cardiac testing began, the men filled out a questionnaire that assessed erectile function.
Almost 55 percent of the men (121 out of 221) suffered from erectile dysfunction. Those men, on average, scored less well on exercise tests and measures of coronary heart disease. They had shorter exercise times, lower treadmill scores, and more frequently had a low ejection fraction.
They also had greater evidence for significant coronary artery blockages during myocardial perfusion imaging -- the portion of the test that measures blood flow to the heart. Forty-three percent of men with ED, compared to 17 percent of tested men without ED, had a myocardial perfusion summed stress score greater than eight, which is "strongly associated with clinically significant obstructive coronary artery disease and a high risk of both cardiac death and nonfatal myocardial infarction," note the authors.
Erectile dysfunction does not cause heart disease, they caution, but it may indicate that the process of arterial damage is well under way.
The risk factors for ED and coronary artery disease are similar, including obesity, diabetes, hypertension, smoking and hyperlipidemia. "As the penile arteries are relatively small in comparison with the coronary arteries," the authors write, "they may be more prone to cause ED with even comparatively small amounts of atherosclerosis."
They caution that there are a number of potential causes for erectile dysfunction, including emotional or psychological components which may not be associated with heart disease. Nonetheless, "the fact that heart disease and ED are linked biologically should come as no surprise," Ward said.
Strong Association between ED and Heart Disease
Because heart disease and ED have a common cause -- damage to blood vessels -- it's been thought that erection problems may be an important symptom of heart disease and related disorders. This newest study shows "a strong association" between ED and heart disease -- and the most "substantial" link yet, writes Ian M. Thompson, MD, a urologist at the University of Texas Health Science Center at San Antonio.
His study appears in the latest issue of The Journal of the American Medical Association.
"Our data suggest that older men in this group have about a twofold greater risk of cardiovascular disease than men without erectile dysfunction," Thompson writes.
Since many men do not get regular checkups, any sign of erectile dysfunction should prompt them to make an appointment for a complete cardiovascular examination, he notes. "This would be especially useful [information] for men who do not have regular medical assessments."
At the study's beginning, 85% had no heart disease; almost half had erectile dysfunction. Among those without ED, 57% eventually developed it within five years.
After taking into account risk factors for heart disease, Thompson found that men who first reported erectile dysfunction during the study carried a 25% increased risk for developing subsequent heart disease during follow-up. In men with ED at the study's start, the risk of developing subsequent heart disease risk was 45%.
The researchers say the risks associated with the development of heart disease in men -- with and without ED -- is in the range of traditional risk factors such as smoking and family history of heart disease.
Over 50% of heart attacks in US occur in patients with normal cholesterol, so it is vital to have other more reliable methods of detecting early cardiovascular disease. EndoPAT is a noninvasive and FDA approved screening tehnology for early detection of those who are likely to have a heart attack or stroke within the next 5-7 years.
Atherosclerosis: Where Erectile Dysfunction and Heart Disease Meet
If atherosclerosis has made your coronary arteries narrow and stiff, that means arteries elsewhere in your body are probably also affected. Atherosclerosis can prevent enough blood flow from reaching your heart, legs, brain and penis. When atherosclerosis affects blood flow to your penis, the blood can't sufficiently fill the penis to allow a suitable erection.
In one study, 64 percent of men who'd had heart attacks had erectile dysfunction before they knew they had cardiovascular disease. Some experts suggest that if you haven't been diagnosed with heart problems; consider erectile dysfunction a wake up call. It could be a warning sign that the blood vessels feeding your heart might also be in trouble. The same factors that raise your risk of atherosclerosis in the arteries in your penis also increase your chances of coronary artery disease. Because the arteries supplying your penis are smaller than the ones to your heart, symptoms may first show up as erectile dysfunction.
Treating the Cause of Erectile Dysfunction
Enhanced External Counterpulsation (EECP) is a potential treatment modality for patients with erectile dysfunction. EECP has traditionally been used to treat angina and other forms of heart disease and it does so by improving vascular function and blood flow to the heart. Several studies have also shown that it also increases blood flow and penile arterial function. EECP is completely safe, noninvasive and has the potential to not only improve erectile dysfunction, but entire vascular system at the same time.
Medications such as Viagra and Cialis do not treat the real problem; they only cover it over and mask the underlying condition, which could be heart disease. These drugs do nothing whatsoever to heal the body. EECP has the potential to get to the root of the problem and not just offer a temporary fix. Most men have the tendency to think, "Well, as long as I have a supply of my medication everything works just fine-that's all that matters". This could be a false sense of security because they could have a much more serious condition that won't be helped by medication.
EECP positive effects include:
•Increase blood flow to the internal iliac arteries 144%; the main blood supply to the penis
•Progressive increase in nitric oxide levels, which augments penile arterial vasodilation enhancing erections. This effect persists beyond the immediate course of therapy
•Improves endothelial function through the entire vascular system.
In one study EECP demonstrated dramatic improvement in patient's with ED. After 20 one hour sessions there was an 80% increase in penile artery blood flow and improvement in erectile function. After the treatment 84% of the patient's showed improvement with 40% having complete resolution.
Viagra and similar drugs may not be the answer to treating erectile dysfunction. They are effective and have restored a more normal sexual relationship for married couples. I have no problem with men using them. That being said, the medical research consistently implies the connection between ED and cardiovascular disease. In my opinion, men who have ED should discuss their potential for having heart disease with their physicians and make decisions accordingly.