Impotence Can Foreshadow Coronary Artery Disease
Doctors should monitor heart health of patients with erectile dysfunction, study says
WEDNESDAY, July 19, 2006 (HealthDay News) -- Impotence is more prevalent among men who have more severe coronary artery disease than among men with low levels of the disease.
And because impotence -- erectile dysfunction -- manifests itself two to three years sooner than coronary artery disease, the condition essentially serves as a "sentinel of the heart" -- or early warning system for cardiac trouble, a new Italian study found.
"It's an important message to get out," said Dr. Ira Sharlip, a spokesman for the American Urological Association. "There's an increasing body of knowledge that tells us that erectile dysfunction is a form of cardiovascular disease and often predates the onset of other forms of clinical cardiovascular disease, specifically coronary disease."
Erectile dysfunction affects, to some degree, 52 percent of men aged 40 to 70 years in the United States and 322 million men worldwide. The condition is linked with age, risk factors for atherosclerosis (hardening of the arteries) and heart disease, according to background information for the study. The paper was expected to be published Wednesday in the online edition of the European Heart Journal.
Erectile dysfunction and coronary artery disease share many of the same risk factors, including diabetes, smoking, high blood pressure, high cholesterol, obesity, depression, and lack of physical activity.
Among people with established coronary artery disease, the prevalence of erectile dysfunction may run as high as 75 percent, the researchers said.
For the study, the researchers evaluated the prevalence of erectile dysfunction and its relationship with coronary atherosclerosis in men with documented coronary artery disease. They hypothesized that erectile dysfunction prevalence corresponds to the severity of heart disease.
The study involved 285 patients with coronary artery disease who were divided into four groups: those with acute coronary syndrome and disease in one vessel; those with acute coronary syndrome and disease in two or three vessels; those with chronic coronary syndrome; and a control group of patients with suspected coronary artery disease but who were found by angiography to have normal coronary arteries.
Just over one-fifth (22 percent) of men who had coronary artery disease in one vessel had erectile dysfunction, compared to more than half (55 percent) of those with two-vessel disease, and nearly two-thirds (65 percent) in the group with chronic coronary syndrome.
Twenty-four percent of those in the control group had erectile dysfunction.
Despite the difference in prevalence between men with one- and two-vessel disease, these men had similar symptoms.
Erectile dysfunction was associated with a four-fold increased risk of multi-vessel disease as opposed to single-vessel disease.
Ninety-three percent of men with both erectile dysfunction and coronary artery disease reported symptoms of erectile dysfunction one to three years before experiencing angina, with two years the average time.
Men with erectile dysfunction should be watched closely for coronary artery disease, the authors stated. Others agreed.
"Men who have erectile dysfunction but no known coronary disease should be evaluated for occult coronary disease and should be counseled about lifestyle," Sharlip confirmed. "The most important point is that primary-care physicians need to learn to ask whether a patient has erectile dysfunction, because it can be an early sign of heart disease."
Dr. James M. Cummings, chief of the division of urology at Saint Louis University School of Medicine, said, "What is further significant is the growing body of literature linking the onset of erectile dysfunction to the symptomatic onset of coronary artery disease, thus giving clinicians a true window of opportunity to evaluate and prevent significant ischemic heart disease in a subgroup of men.
"It is more apparent than ever that men with onset of erectile dysfunction without already well-defined risk factors should probably have some type of cardiovascular evaluation," he added.
The National Institute of Diabetes and Digestive and Kidney Diseases can tell you more about erectile dysfunction.