Several studies have shown that erectile dysfunction (ED) is a predictor for heart disease. When the first symptoms of erectile dysfunction occur, the doctor should not just prescribe the little blue pill (Viagra), but should carefully check for coronary heart disease (CHD). It has been shown that ED in men without CHD occurs 2 to 5 years earlier than in men who develop heart disease. So there is ample time to do blood tests, check for hardening of the coronary arteries and prescribe measures to reduce the risk for heart disease.
Comparison with Framingham Heart study
A 2010 ED study followed 1,709 men aged 40–70 years for 11.7 years.
All men were self-reporting their ED. They were compared to the traditional Framingham study risk factors that were fulfilled by these men and death rates were also recorded over almost 12 years. It was noted that there was a large overlap of patients, who had cardiovascular risk factors, but in both groups there were patients who had cardiovascular disease with no ED or patients who had ED, but no cardiovascular risk factors.
The rate of heart attacks in the group of men with ED was 21.0 per 1,000 patient years, which was nearly identical to the heart attack rate among men aged 55–64 in the original Framingham Heart Study, which was 21.4 per 1,000 patient years.
Checking the heart function
Heart function was checked by blood tests on the one hand and a treadmill test on the other hand. Using the well established treadmill test patients could be classified into low, medium and high risk for developing cardiovascular disease. Patients with ED and mild CVD were allowed to start the Viagra type drugs or PDE5 inhibitor drugs. This is a group of drugs that selectively vasodilates penile blood vessels, but other blood vessels, particularly lung vessels also respond to them, which is called a side effect.
Patients in that study had the following tests done: Physical exam, ED severity assessed by a validated scale, Resting electrocardiogram, Fasting glucose, serum creatinine level and albumin for the creatinine ratio, and lipid profile. In addition testosterone levels were tested and if they were found to be low, testosterone replacement therapy was given. In this context it is important to know that testosterone is a strong supporter for the heart and the blood vessels as there are testosterone receptors in blood vessels and the heart. Many physicians think that aging, which leads to a slow loss of testosterone and a lack of exercise are the main culprits when it comes to the development of heart attacks and stokes in older men. Publications from Dr. A. Morgentaler support this.
Effectiveness of dietary changes
A 2014 publication on the Mediterranean diet showed that adherence to a healthy heart diet in both men and women reduces their salt intake, results in weight loss, improves their lipid values and most of all significantly reduces their heart attack risks!
Summary of ED studies leading to heart attacks
- When a man loses erections, this can be a sign of decreasing testosterone, so testosterone levels should be checked and if low, should be replaced.
- However, ED development can also be a sign of beginning hardening of the penile arteries preceding coronary vessel hardening (usually with a lag period of 2 to 5 years). For this reason a referral to a cardiologist to check the heart vessels would be indicated.
- Consider these risk factors: When ED of all men was taken together in a 12-year follow-up study and compared to men without ED, they had a 40% higher risk of developing a heart attack. This risk had developed independently of age and traditional cardiac risk factors.
- Another study showed that the age- and Framingham-adjusted heart attack risk was 1.6-fold for reduced erectile rigidity and 2.6-fold for severely reduced erectile rigidity. It is not surprising therefore, that severely reduced erectile rigidity was associated with an approximately 80% higher risk of subsequent development of heart attacks (versus only 40% for mildly reduced rigidity as already mentioned).
- The biological mechanisms that link ED and CVD are relatively well known. The first stage is endothelial dysfunction, which is characterized by impaired nitric oxide production from the endothelial lining. Secondly, this precedes the development of atheromatous plaques. Atheromatous plaques are the link between ED and CVD. Given the fact that the penile arteries have a smaller diameter, it is not surprising that the penile corpora may be more susceptible to the reduced blood flow compared to the larger blood vessels of the heart or brain. This fact explains why ED develops first before heart attacks and strokes develop.
Some people are prudish when it comes to the male genitals. But if the research that has been discussed here would be applied to all males who are noticing that their erections are waning, a lot of potential deaths from heart attacks could be prevented. You see, the important finding is that we have 2 to 5 years to help this person with erective problem. In this time span there is also a chance to sort out whether or not he has heart vessel or brain vessel disease. It is not just a funny story; it is a matter of life and death. In the early cases it may just be an indication that testosterone is missing and your physician can measure this. In more severe cases it is imperative that traditional Framingham risk factors are determined and used as the basis to create a remedial program to avoid risks for heart attacks or strokes.
Watch your body, look for changes and discuss changes like ED with your doctor! It is not only about your sex life. You need a beating heart first!
More info about heart disease: https://nethealthbook.com/cardiovascular-disease/heart-disease/
More info about erectile dysfunction: https://nethealthbook.com/mens-health/erectile-dysfunction/