Erectile Dysfunction Exhibit Early Signs Of Coronary Artery Disease

International experts are calling for all men experiencing impotence to undergo thorough medical assessments, after an extensive review showed that a significant proportion of men with erectile dysfunction exhibit early signs of coronary artery disease (CAD).

The paper shows that men with erectile dysfunction will often develop coronary symptoms within two to three years of impotence and actually experience a cardiovascular event, such as a heart attack, within three to five years. The authors stress that it is vital that clinicians stabilise cardiovascular function and control any symptoms before even considering initiating any ED therapy.

Dr Graham Jackson, a London-based cardiologist and Chair of the Sexual Advice Association, teamed up with 11 experts from all over the UK, Italy, Greece and the USA to analyse the findings of more than a hundred studies on the links between erectile dysfunction and CAD.

They concluded that:

·    erectile dysfunction in otherwise healthy men and those with type 2 diabetes may be associated with early subclinical signs of CAD, including reduced blood flow and calcification of the arteries.

·    Men with erectile dysfunction generally exhibit more severe CAD and dysfunction in the left ventricle of the heart than those without erectile dysfunction and the severity of the erectile dysfunction may also be correlated with the severity of the CAD.

·    In around two-thirds of men, CAD is preceded by erectile dysfunction. The association in younger men aged between 40 and 69 is much clearer than in men over 70.

·    erectile dysfunction is associated with an increase in all-cause mortality, primarily through its associated with CAD.

A number of studies have sought to quantify the increased risk.

·    One study found that men aged between 30 and 39 with moderate to severe erectile dysfunction have a 14 per cent higher risk of developing CAD within ten years than men without CAD (4.9% and 4.3% respectively). This figure rose to 27 per cent in men aged 60 to 69  (21.1 per cent and 16.6 per cent respectively).

·    Other studies suggest that the increased risk can range from 30 to 60 per cent, compared with a 40 per cent increase for a man with a family history of heart attacks and a 10 per cent increase for a 20mg/dl rise in serum cholesterol concentration.

The authors suggest that the link between the two conditions could be due to atherosclerosis, a systemic condition where plaque builds up inside the arteries, leading to restricted blood flow.

"It has been suggested that because the arteries supplying the penis are smaller than those supplying the heart, they will be affected by reduced blood flow - a major cause of erectile dysfunction - before the symptoms of CAD develop" explains Dr Jackson.

"This theory may underpin the findings that men with erectile dysfunction seldom report overt symptoms of CAD, but those with CAD often report pre-existing erectile dysfunction symptoms." The paper goes on to discuss prevention strategies and how patients should be assessed, tested, managed and followed up. Special guidance is also provided on dealing with patients with diabetes. "The evidence supporting the relationship between erectile dysfunction and cardiovascular disease has continued to increase over recent years and yet recognition of the association remains limited among healthcare professionals and the general public" concludes Dr Jackson.