Erectile Dysfunction Can Signal Heart Trouble

Men with condition performed more poorly on cardiac stress test, researchers found

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By Steven Reinberg
HealthDay Reporter

MONDAY, Jan. 23, 2006 (HealthDay News) -- Erectile dysfunction may be a warning sign of serious heart disease, researchers from the University of Chicago report.

Recent studies have tied erectile dysfunction to vascular disease, but this study links it with abnormal results on cardiac stress testing.

One recent report found that men who had no problems with sexual function at the start of the seven-year study but later developed erectile dysfunction were 25 percent more likely to have a heart attack or stroke compared with those who did not develop erectile dysfunction.

The latest study appears in the Jan. 23 issue of the Archives of Internal Medicine.

"Among patients with symptoms that require stress testing, we found a very high prevalence of erectile dysfunction," said lead researcher Dr. R. Parker Ward, director of the university's cardiology clinic. "Over 50 percent had some degree of erectile dysfunction."

In their study, Ward and colleagues examined 221 men who had nuclear stress testing, a common, noninvasive way of determining the severity of coronary heart disease. Before testing, the men completed a questionnaire that assessed erectile function.

They found that 54.8 percent of the men had some degree of erectile dysfunction. In addition, men with erectile dysfunction had poorer scores on exercise tests and other measures of coronary heart disease. These men also had evidence of significant coronary artery blockages.

"Erectile dysfunction was an important risk factor for abnormal findings on the stress test," Ward said. "These suggested severe blockages in the coronary arteries, heart weakness and other abnormalities that predict cardiovascular risk."

According to Ward, the findings suggest that erectile dysfunction is a stronger risk factor for an abnormal stress test than some traditional risk factors, such as high blood pressure, diabetes and high cholesterol.

"Erectile dysfunction may be something that physicians should do a better job of asking patients about and considering as a risk factor for heart disease," Ward said. "Erectile dysfunction should be recognized as a warning sign for potential underlying heart disease, and should be considered a risk factor that should be mentioned to your physician."

However, one expert thinks erectile dysfunction is not really useful as a sign of cardiovascular disease.

"With regard to using erectile dysfunction to guide cardiovascular evaluation and treatment, I don't think there is any evidence that that's useful," said Dr. Harlan M. Krumholz, a professor of cardiology at Yale University Medical School.

Krumholz noted that in the study, all the men had been referred for stress tests based on the presence of risk factors for heart disease. There were a lot of people without erectile dysfunction who had poor scores on the stress test and people with erectile dysfunction who had good scores, he said. "So, I don't know what would happen if you started doing stress tests on everyone with erectile dysfunction."

Erectile dysfunction may be a sign of heart disease, Krumholz said. But it may also be a sign of other underlying problems.

The best way to find heart disease is for doctors to take a good history and focus on traditional risk factors, Krumholz said. "It's not clear to me that erectile dysfunction will rise to the level of a new risk factor," he added.

Another expert disagreed, however. "If this research is replicated, it may make it more important for men with erectile dysfunction to seek out medical evaluation for cardiovascular disease," said Dr. Ian M. Thompson, holder of the Henry B. and Edna Smith Dielman Memorial Chair in Urologic Science at the University of Texas Health Science Center, in San Antonio.

"Obviously, the other side of this is that there is considerable evidence that vascular disease can be prevented or delayed through behavioral interventions or medications," Thompson said. "The next logical step would seem to be to ask the question: Do these interventions not just reduce the risk of heart disease and stroke, but also reduce the risk of erectile dysfunction?"

More information

The National Institute of Diabetes and Digestive and Kidney Diseases can tell you more about erectile dysfunction.

SOURCES: R. Parker Ward, M.D., assistant professor, medicine, and director, cardiology clinic, University of Chicago; Harlan M. Krumholz, M.D., professor, cardiology, Yale University Medical School, New Haven, Conn.; Ian M. Thompson, M.D., Henry B. and Edna Smith Dielman Memorial Chair in Urologic Science, University of Texas Health Science Center, San Antonio; Jan. 23, 2006, Archives of Internal Medicine

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