Erectile Dysfunction And Cardiovascular Disease Linked

Nearly every man who has had a heart attack has problems with erectile dysfunction ED). But it is also the case that many or even most men who have ED are at risk of cardiovascular disease several months to several years later.

The Australian National Heart Foundation and the New South Wales Cardiovascular Research Foundation have conducted a long-term study known as 45 and Up, following the health of 95,088 Australian men, average 62, through mail-in questionnaires and studies of the national health service records.

The 45 and Up research team recently announced findings that men who have "severe" erectile dysfunction (never able to get an erection strong enough for satisfactory sexual activity) are at considerable risk for certain kinds of cardiovascular disease. Men who have severe erectile dysfunction are:

• Up to 53% more likely to be diagnosed with some form of cardiovascular disease.
• Up to 95% more likely to be diagnosed with ischemic heart disease.
• Up to 126% more likely to be diagnosed with myocardial infarction (heart attack).
• Up to 229% more likely to be diagnosed with peripheral vascular disease (either peripheral arterial disease or venous insufficiency).
• Up to 415% more likely to be diagnosed with peripheral atherosclerosis (blockages in arteries outside the heart).
• Up to 2256% more likely to be diagnosed with a heart injury known as left bundle branch block.
• Up to 2320% more likely to be diagnosed with congestive heart failure.

Just how many men suffer severe erectile dysfunction, never able to overcome impotence to have sexual relations? The 45 and Up survey, not unexpectedly, found that the frequency of severe impotence increased with age.

• Only 2% of men aged 45 to 54 reported severe ED.
• About 7% of men aged 55 to 64 reported severe ED.
• About 20% of men aged 65 to 74 reported severe ED.
• About 50% of men aged 75 to 84 reported severe ED.
• Over 75% of men 85 and older reported severe ED.

Men who have severe erectile dysfunction are also more than twice as likely to die of other causes than men who do not. A significant percentage of men (about 2% of all men, but about 10% of men who have ED) died within 3 years of reporting their sexual dysfunction. But, assuming that loss of the ability to have sex doesn't cause men just to give up, why should erectile dysfunction be so clearly linked to cardiovascular disease?

Is There A Connection Between ED And Heart Disease, Heart Attack, And Death From Cardiovascular Disease?

The 45 and Up study is the first large-scale study of men that finds a significant connection between the inability to have sex and the subsequent development of heart disease and even deaths from heart disease. The complete inability to have sex predicted later cardiovascular illness even when tobacco smoking, alcohol consumption, treatment for high blood pressure, treatment for high cholesterol, physical activity, marital status, income, education, body mass index (BMI), and diabetes are taken into account. But does erectile dysfunction really cause heart and blood vessel disease?

The Australian research team does not think so. They believe that erectile dysfunction is not so much a cause of heart disease as a it is a diagnostic symptom or "biomarker" of cardiovascular disease before it is otherwise detectable.

The researchers speculate that erectile dysfunction is an obvious way to detect the earliest stage of cardiovascular disease, which is often understood as endothelial dysfunction.

Endothelial Dysfunction Leads to Both Erectile Dysfunction and Heart Disease

What is endothelial dysfunction? The epithelium is the lining of the blood vessel. To let blood flow into the penis, the epithelium of the blood vessels making up the "pump" of the penis known as the cavernus cavernosum has to relax. To keep that blood in the penis so it can stay erect, the epithelium of the blood vessels that make up the cavernus cavernosum has to tense up and tighten.

There is a similar process in the endothelial layer of blood vessels all over the body. Sometimes blood vessels need to relax. Sometimes they need to tighten. When blood vessels lose their ability to do this, even before they are "clogged" by atherosclerosis, at first ED is a problem and then problems show up elsewhere in the body.

What Every Man Over 45 Needs to Do About ED and Cardiovascular Disease

What should a man do if he experiences ED? There are several other causes of impotence, including testosterone deficiency, stress, and simply being with the wrong partner or having unrealistic expectations. These issues should be addressed. But when a man gets a prescription for Viagra, Levitra, or Cialis, he should also get an appointment for an EKG and a stress test, and get regular checkups of cardiovascular health.