Erectile Dysfunction May Signal Serious Heart Problems

Erectile dysfunction (ED) is often a matter of the heart, but new research shows that more than romance is at stake. Two new studies of men with type 2 Diabetes found that erectile dysfunction (ED) was a major early warning sign for serious heart disease, including heart attack and death.

One of the studies also showed that cholesterol- lowering medications (statins) could cut the risk of heart problems by about one-third--and suggested that other compounds in the same drug category might offer protection. The research, which was published in most recent issue of the Journal of the American College of Cardiology (JACC), underscores the importance of encouraging men to report ED to their physicians, and of focusing treatment not only on overcoming sexual dysfunction but also on improving overall cardiovascular health. The development of erectile dysfunction should alert both patients and healthcare providers to the potential future risk of coronary heart disease.

Other risk factors include: poor blood glucose control, high blood pressure, high cholesterol levels, smoking and obesity. Diabetes, erectile dysfunction and heart disease share a critical, dangerous link... damage to the blood vessels by high blood sugar levels. The same process that impedes the extra blood flow needed to maintain an erection can have serious consequences in the heart. When the smoothness and reactivity of the blood vessel are damaged, this process encourages local inflammation on the inner surface of the blood vessels and the deposition of cholesterol, resulting in formation of dangerous clots and atherosclerosis. Therefore, there is a high risk of blockage of blood vessels in the heart, which can lead to a heart attack.

Men typically show signs of ED more than three years before the onset of symptoms of coronary heart disease. In one study of diabetic men, symptoms of ED always preceded coronary symptoms.

Men who had ED at the beginning of the study were far more likely to develop one of the signs of coronary heart disease--or a "CHD event"--than were men who initially did not have ED. Statistical analysis showed that out of every 1,000 Diabetic men with ED, 19.7 could be expected to experience a CHD event each year, as compared to only 9.5 of 1,000 diabetic men without ED.

The research team then performed an analysis that included many different characteristics that, like erectile dysfunction, were associated with the development of CHD, including age, high blood pressure, the need for cholesterol-or blood- pressure-lowering medications, the duration of diabetes, and damage to the kidneys or the eyes as a result of diabetes. Even when these characteristics were taken into account, ED was found to be an independent early warning sign of coronary heart disease. In fact, ED signaled a 58 percent increase in the risk of CHD. Only spillage of large amounts of protein in the urine--a sign of extensive kidney damage--was a stronger warning sign, doubling the risk of heart disease.

Another study, conducted by researchers from four medical centers in Italy, focused on 291 men who not only had type 2 Diabetes but also silent CHD (Coronary Heart Disease) discovered by stress testing and confirmed by x-ray angiography. Of these, 118 had ED at the beginning of the study. They found that patients who had ED at the beginning of the study were twice as likely to suffer a major adverse cardiac event when compared to those without ED. Thus, ED remained a significant risk factor for developing heart disease after controlling for other cardiovascular risk factors.

"Men should know that ED is a true harbinger of atherosclerotic coronary heart disease," he said. Dr. Kloner, who wrote an editorial about the new studies in the same issue of JACC, also noted that not only have statins been shown to reduce the risk of cardiovascular illness in diabetic patients, controlling blood pressure and other risk factors is also critical. "In diabetic patients, it is important to not only control the blood sugar level, but also to keep blood pressure below 130/80 mmHg and reduce 'bad' (low-density-lipoprotein, or LDL) cholesterol to less than 100 mg/dL. If a patient smokes, a smoking cessation program is crucial," Dr. Kloner said.

Improvements in the control of blood sugar and other cardiovascular risk factors reduce the likelihood of developing erectile dysfunction or suffering a heart attack or other serious heart disease. Patients who have ED in addition to diabetes-related eye problems and kidney problems at higher risk for death or cardiovascular disease. All are relevant to those who suffer from Diabetes. Proper information about these conditions and aggressive treatment of critical warning signs with appropriate medications, healthier daily dietary habits, increased physical activity and proper nutritional intake will help patients to focus on improving their own health.