Erectile Dysfunction a Strong Harbinger of Heart Trouble (HealthDay)

MONDAY, May 19 (HealthDay News) -- Findings from two studies ofmen with diabetes add to the evidence that erectile dysfunction can be apowerful early warning sign for serious heart disease.

A Hong Kong study of 2,306 men with diabetes but no signs of heartdisease found that those with erectile dysfunction at the start were 58percent more likely to have a heart attack or other major cardiac problemover the next four years than those with adequate sexual function.

And Italian physicians who followed 291 men who had diabetes and earlycoronary heart disease for four years reported similar numbers -- thosewith erectile dysfunction were twice as likely as men without the problemto have major adverse events, including strokes.

There's a physical connection between male sexual failure and heartdisease, involving the effect of diabetes on the nervous system and theblood vessels, said Dr. E. Scott Monrad, director of the CardiacCatheterization Lab at Montefiore Medical Center in New York City.

"Neuropathy would interfere with the neurogenic responses feeding intoproper erection," Monrad said. "And obstruction of blood flow into thearteries reduces the pressure needed to achieve erection."

It has been known that erectile dysfunction shares many risk factorswith coronary heart disease, such as high blood pressure, smoking anddiabetes, according to Dr. Robert A. Kloner, a professor of medicine atthe University of Southern California, who wrote an accompanying editorialon the reports, which were expected to be published in the May 27 issue ofthe Journal of the American College of Cardiology.

"What is new here is that erectile dysfunction remained a significantrisk factor for developing heart disease after controlling for othercardiovascular risk factors," Kloner said in a statement.

"These reports add two things to what we already know," said Dr. R.Parker Ward, an associate professor of medicine at the University ofChicago, who led an earlier study linking erectile dysfunction with heartdisease. "One is that they indicate the importance of erectile dysfunctionin diabetic patients in terms of predicting future cardiovascular events.These studies suggest that the additional presence of erectile dysfunctionplaces them at incrementally higher risk. Secondly, they show that evenwhen considered in combination with traditional risk factors, erectiledysfunction offers incremental information about the risk of futurecardiovascular events."

Cholesterol-reducing statins lowered the incidence of cardiac events bya third, the Italian researchers reported, and Viagra and other drugs forerectile dysfunction also appeared to lower the risk, although thereduction was not statistically significant, meaning that it could be dueto chance.

"I strongly caution that we do not have enough evidence at this pointthat the drugs used for the treatment of erectile dysfunction have anybeneficial effects on the development of heart disease," Ward said.

Physicians should be more forward in talking about sexual performancewith men, Monrad said, since "this may prove to be a very sensitive markerfor all the other things we measure for cardiovascular risk, an early andmore sensitive measure if we could get over all our puritanicinhibitions."

Acknowledgment of erectile dysfunction "should prompt us to be evenmore aggressive about lifestyle change, in diet and exercise," Page said."It potentially may suggest more aggressive treatment of risk factors suchas high blood pressure and cholesterol."

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