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Risk of Heart Attack For Men ED or Impotence; Several Studies Found

Sexual dysfunction (ED) or impotence is often associated with disorders such as diabetes, high blood pressure, heart disease, nervous system disorders, and depression. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. In general, erectile dysfunction is quite likely to be psychological rather than physical if the man is still waking with morning erections or by masturbation.

There is growing evidence that patients presenting with ED should be investigated for cardiovascular disease (CVD), including diabetes, even if they have no symptoms. Early detection could facilitate prompt intervention and a reduction in long-term complications. Treatments that reduce endothelial dysfunction offer the potential of improving the functioning of the entire vascular system, improving outcomes in CVD and diabetes, as well as providing effective treatment for ED or impotence.

The incidence of erectile dysfunction in men 40 to 69 years old for during an average 8.8-year follow up study by England Research Institutes, Watertown, MS found that risk of erectile dysfunction was about 26 cases per 1,000 men annually, and increased with age, lower education, diabetes, heart disease and hypertension. Erectile dysfunction and coronary heart disease share some behaviorally modifiable determinants in men & modification of coronary risk factors can prevent ED and whether ED or impotence may serve as a sentinel event for coronary disease; study suggested.
Erectile dysfunction (ED) is a common condition and studies predict that it will become even more common in the future. There is increasing evidence to suggest that it is predominantly a vascular disease and may even be a marker for occult cardiovascular disease; according to UK journal.
Another study by University Clinics of Brussels and concluded that hyperlipidemia is common in ED patients. HDL-C and TC/HDL-C ratio are predictors of ED or impotence. These patients have a high risk of later developing coronary heart disease (CHD). Erectile dysfunction might therefore serve as sentinel event for CHD.
Joint clinical research by St. Paul Heart Clinic & St. Paul Epicenter for Sexual Health and Medicine suggested that patients with ED or impotence but no clinical cardiovascular disease have a peripheral vascular defect in endothelium-dependent and -independent vasodilation that occurs before the development of other overt functional or structural systemic vascular disease and is independent of other traditional cardiovascular risk factors.
Study by Ludwig Boltzmann Institute for Urological Oncology, Vienna, Austria also made good evidence and suggested at conclusion that overall, 32.2% of men in our study had ED or impotence according to the IIEF-5. Apart from age, most important risk factors for ED were diabetes, hyperlipidemia, lower urinary tract symptoms, hypertension and psychological stress.
The University of Chicago Hospitals, Chicago studied over 221 men with ED or impotence referred for stress myocardial perfusion single-photon emission computed tomography (MPS) and found association with markers of adverse cardiovascular prognosis, and is an independent predictor of severe coronary heart disease; ultimately may be suspected coronary heart disease.
Another study done by Department of Urology, University Vita e Salute-San Raffaele, Via Olgettina, Milan, Italy and cited "a significant proportion of patients with angiographically documented coronary artery disease have erectile dysfunction and that this latter condition may become evident prior to angina symptoms in almost 70% of cases".
Endothelial dysfunction and atherosclerosis of blood vessels that supply the penis are associated with the same cardiovascular risk factors that affect the coronary arteries: smoking, lipid abnormalities, hypertension, and diabetes. Same like study at the University of L’Aquila, L’Aquila, Italy and found increased biochemical measures of Endothelial cell activation (ECA; an initiating event in atherosclerosis) were associated with ED independent of coexisting cardiovascular risk factors (VRFs) and overt vascular damage, suggesting that ED or impotence is a sentinel of early atherosclerosis.
"Our study first shows a strong and independent association between ED and silent coronary artery disease (CAD) in apparently uncomplicated type 2 diabetic patients. If our findings are confirmed, ED or impotence may become a potential marker to identify diabetic patients to screen for silent CAD. Moreover, the high prevalence of ED or impotence among diabetics with silent CAD suggests the need to perform an exercise ECG before starting a treatment for ED, especially in patients with additional cardiovascular risk factors"; result in a study published in the journal of American Heart Association, Inc.
Few men may realize it, but if they're having problems achieving or sustaining ED or impotence, it may signal underlying heart trouble. Erectile dysfunction, or impotence, affects more than 18 million American men, according to a recent study by researchers at the Johns Hopkins Bloomberg School of Public Health.

And now a growing body of research ties erectile dysfunction to vascular diseases, such as coronary artery disease.

"Erectile dysfunction is often caused by vascular disease," explained Dr. Ian Thompson, professor and chairman of the department of urology at the University of Texas Health Science Center at San Antonio. "A man could perceive decreased blood flow to the penis as being a less strong, a weaker erection, and that may actually be one of the first indicators of blood vessel disease."

One recent report found men with erectile dysfunction (ED) or impotence had poorer scores on exercise tests and other measures of coronary heart disease. They also had evidence of significant coronary artery blockages. "Our study found that among men who were sent for a stress test by their doctor, the presence of erectile dysfunction was a potent predictor -a strong risk factor -- for significant underlying heart disease," said lead researcher Dr. R. Parker Ward, an assistant professor of medicine and director of the cardiology clinic at the University Of Chicago Hospitals.

"It was a stronger risk factor than some of the traditional risk factors we commonly ask questions about, things like high blood pressure and high cholesterol," he added. Ward's study, published last year in the Archives of Internal Medicine, involved men who had been referred to cardiologists for nuclear stress testing, a noninvasive way to determine the severity of coronary heart disease. But even among men without heart symptoms, erectile dysfunction is a strong risk factor for future risk of heart attack, he noted.

In the same issue of the journal, Dr. Steven A. Grover and colleagues studied a group of 3,912 Canadian men, nearly half of whom reported having erectile dysfunction in the four weeks prior to visiting their family physicians. The men's cholesterol, glucose and blood pressure measurements were taken.

"When you calculated a global cardiovascular risk, [it] was strongly associated with the probability that you had erectile dysfunction (ED or impotence)," said Grover, a professor of medicine and epidemiology at McGill University Health Centre in Montreal. "And subsequently there have been other studies that have shown that people who have erectile dysfunction are, in fact, more likely to develop cardiovascular disease in the future."

Thompson and his colleagues provided the first substantial evidence linking erectile dysfunction and subsequent risk for heart disease in a December 2005 report in the Journal of the American Medical Association. Yet the connection is not as well recognized among doctors and patients as cardiologists and urologists think it should be.

"A lot of men don't have physicians," Thompson explained. "They may not know what their blood pressure is or their lipid profiles, or they may be smokers, and they may never have been counseled to stop smoking or to reduce their weight.”We think that if men with erectile dysfunction (ED) or impotence went to see their physicians, it may enable the interaction with the physician to discuss other coronary risk factors," he said.

Erectile problems aren't always vascular in nature. Sometimes the trouble is psychological or neurological and wouldn't necessarily be associated with a higher risk of heart disease, Ward cautioned. Still, research linking erectile dysfunction (ED) or impotence and heart disease suggest that a proactive approach is the best medicine.

"We as physicians should be asking about, and men should be reporting to their physicians, symptoms of ED or impotence, so it can be considered as we work to modify their risk -- treat blood pressure, cholesterol more aggressively, advise healthy lifestyle changes like exercise and healthy diet," he said.

Lifestyle changes are associated with improvement in sexual function in about one third of obese men with erectile dysfunction (ED) or impotence. Smoking, alcohol consumption, and television viewing time were also associated with increased prevalence of erectile dysfunction. Men who have no chronic medical conditions and engaged in healthy behaviors had the lowest prevalence.

Another study also supported this study and also shown that one-third of obese men with ED or impotence can regain their sexual activity after 2 y of adopting health behaviors, mainly regular exercise and reducing weight.

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