Erectile Dysfunction: Another Cardiovascular Risk Factor?
If you have erectile dysfunction (ED) your chances of having heart disease go up. This a major reason why you should not ignore ED even if you’re not sexually active. This study from Australia on 95,038 men over the age 45 confirms the results of other studies that erectile dysfunction is a harbinger or marker for cardiovascular disease. This is important to recognize because a significant number of cases of cardiovascular disease occur in patients without the traditional risk factors for heart disease: high blood pressure, diabetes, smoking, high LDL cholesterol, sedentary lifestyle, and obesity. Cholesterol alone misses 50% of those with heart disease. And, 50% of people who die from a heart attack or stroke had no previous signs or symptoms.
Erectile dysfunction has many contributing factors, but it is now believe that vascular causes are the main factor in its development.
What Causes Erectile Dysfunction?
The main culprits are medications, chronic disease (diabetes, kidney disease, heart disease), excessive alcohol use, stress, smoking, obesity, and lack of physical activity. Medications that affect erectile function include some blood pressure medications, cholesterol lowering medications, and the SSRI antidepressants. All of these class of medications are extensively used these days.
The Australia study was unique in that it studied the effects of severity of erectile dysfunction with a range of cardiovascular outcomes in men with existing and without cardiovascular disease. The study defined “severe” dysfunction as being able to never “to get and keep an erection that is firm enough for satisfactory sexual activity”.
First, the study found that severe erectile dysfunction was more common in smokers, those with existing diabetes or heart disease, and those being treated for high blood pressure and cholesterol. In this study severe erectile dysfunction was more common in men with lower alcohol consumption – which is contrary to other studies.
Secondly, men with severe erectile dysfunction were 1.5 to 2 times more likely to have heart disease and peripheral vascular disease, and were more likely to die over an average follow up period of 2.8 years. The study’s investigators consider erectile dysfunction to be a biomarker for heart disease, but did not go so far to say that it is an independent risk factor for heart disease.
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