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Erectile Dysfunction-Heart Disease Link Needs More Focus

Urologist faults researchers, clinicians for failing to advocate routine screening of male patients

WEDNESDAY, Oct. 22 (HealthDay News) -- Because erectile dysfunction is an early warning sign of cardiovascular events, clinicians should not be squeamish about screening their male patients for the condition, according to a letter published Oct. 21 in BMJ Online First.

Geoffrey I. Hackett, M.D., of Good Hope Hospital in Birmingham, U.K., responded to a study published in the Aug. 28 issue of BMJ: "Will screening individuals at high risk of cardiovascular events deliver large benefits? Yes."

As a urologist with 30 years' experience, Hackett expressed concern that the study ignored evidence showing that erectile dysfunction is associated with vascular disease in smaller arteries and that its presence is a two- to three-year early warning sign of myocardial infarction. He stated that erectile dysfunction increases the risk of coronary events by 50 percent and is an especially strong predictor of coronary risk in men with type 2 diabetes.

"Despite this evidence we don't even screen for erectile dysfunction or low testosterone in type 2 diabetes or patients with coronary heart disease," Hackett writes. "We prescribe drugs for coronary heart disease that make erectile dysfunction worse, even though there are drug treatments as effective which improve it, and then make the patients pay privately because we treat erectile dysfunction as a recreational or 'lifestyle' issue. Continuing to ignore these issues on the basis that cardiologists feel uncomfortable mentioning the word erection to their patients is no longer acceptable and probably clinically negligent."

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