If you're a man living with heart disease, you have an increased risk of heart attack, stroke, and premature death. But if you're unfortunate enough to have heart disease and erectile dysfunction -- an inability to maintain an erection sufficient for sex -- you have an even higher risk.
That's the conclusion of a study published in the April 30, 2010 issue of Circulation. In that study, German researchers collected data on 1,519 men with established heart disease, 55 percent of whom also had erectile dysfunction. Compared to men without erectile dysfunction, they found that those with both conditions were nearly twice as likely to die from any cause. They also found that men with both conditions were about twice as likely to either have a heart attack or die from heart disease, 20 percent more likely to be hospitalized for heart failure, and 10 percent more likely to have a stroke.
The men were enrolled in two clinical trials. In one trial, they were randomly selected to take blood pressure-lowering drugs: either the ACE inhibitor ramipril (Altace), the angiotensin II receptor antagonist telmisartan (Micardis), or both drugs. In the second trial, the men were randomly selected to take either Micardis or a placebo. Because none of these treatments had any effect on erectile dysfunction, the researchers found that erectile dysfunction itself is an independent predictor of heart attack, stroke, heart failure, cardiovascular mortality, and all-cause mortality.
The take-home message: Erectile dysfunction is just as important a risk factor for heart disease as high blood pressure or elevated cholesterol. "If a man has erectile dysfunction, then he needs to ask his physician to check for other risk factors of cardiovascular disease," said lead researcher Michael Bohm, M.D., of the University of Saarland.
The German study is part of a growing body of evidence suggesting that erectile dysfunction is an early-warning sign of heart disease. That's because erectile dysfunction often results from a buildup of plaque in the small arteries that supply blood to the penis. The same process -- atherosclerosis (commonly known as hardening of the arteries) -- is what causes a buildup of plaque in the larger arteries that supply blood to the heart and brain. So men may notice its effects on their sex life long before developing a heart attack or stroke.
If you have erectile dysfunction, a number of factors may increase the odds that it's associated with atherosclerosis and heart disease:
- Diabetes.
- Overweight and obesity.
- High cholesterol.
- High blood pressure.
- Smoking.
- Depression.
- Younger age. If you're under age 50 and have erectile dysfunction, it's much more likely that you have underlying heart disease. In men over age 70, it's much less likely that heart disease is the culprit.
- Low testosterone. A recent study presented at the European Congress of Endocrinology found that low T levels in men seeking treatment for erectile dysfunction were strongly associated with an increased risk of death from heart disease.
Note: Some blood pressure medications can adversely affect a man's sex life, especially diuretics and beta blockers. If you suspect that such medications are causing erectile dysfunction, talk to your doctor about switching to another class of medications such as ACE inhibitors, calcium channel blockers, angiotensin II receptor blockers, or alpha blockers.
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