When the definitive history of erectile dysfunction and its treatment is eventually written, it may be seen as just as much a victory for cardiovascular disease diagnosis and treatment as for the treatment of sexual problems. That’s because evidence has been rapidly accumulating over the past decade that erectile dysfunction should be considered as much a vascular disorder as a sexual one.
Erectile Dysfunction and Heart Disease Share Many Risk Factors
Once drugs like Viagra, Levitra, and Cialis were introduced, it didn’t take long for doctors and researchers to realize that erectile dysfunction and heart disease share several risk factors. If you have any of the following risk factors, your risk is elevated for both erectile dysfunction and heart disease:
- Diabetes
- High levels of LDL (“bad”) cholesterol
- Smoking
- High blood pressure
- Family history
- Older age
- Being overweight
- Having depression
The “Artery Size Hypothesis” Linking Erectile Dysfunction and Heart Disease
Back in 2005, Italian researchers published a paper in the American Journal of Cardiology proposing what they called the “artery size hypothesis” linking erectile dysfunction and coronary artery disease. The theory is that all major vascular beds in the body should be affected to the same extent by artery disease, yet symptoms don’t become evident all at once.
The researchers proposed that the different sizes of arteries supplying different vascular beds account for the progression of symptoms. They believe that larger vessels can better tolerate the same amount of plaque than smaller ones, which makes sense. Because penile arteries are much smaller in diameter than the big coronary arteries, patients with erectile dysfunction may not have any traditional symptoms of coronary artery disease.
But patients who do have symptoms of coronary artery disease frequently have erectile dysfunction. For this reason, more doctors are encouraging some patients with erectile dysfunction to be tested for coronary artery disease, even if they don’t have heart disease symptoms. It’s a lot easier to treat early heart disease than advanced heart disease, and erectile dysfunction can be an indication of early, pre-symptomatic coronary disease.
How Diabetes Figures Into It
A 2004 study published in Circulation: Journal of the American Heart Association studied the association between erectile dysfunction and “silent” heart disease (heart disease that presents no symptoms) among men with type 2 diabetes. To that point, nobody had evaluated the prevalence of erectile dysfunction among diabetic men with silent heart disease. These researchers evaluated prevalence of erectile dysfunction among a group of diabetic men without silent heart disease and a similarly sized group of diabetic men with silent heart disease. The groups were comparable in age and duration of their diabetes.
Researchers found that the prevalence of erectile dysfunction was significantly higher in men with silent heart disease than in those without it. In fact, among a range of factors including smoking, HDL, and LDL levels associated with silent heart disease, erectile dysfunction appeared to be the best predictor of silent heart disease. Wow! If you’re a man with apparently uncomplicated type 2 diabetes and erectile dysfunction, your doctor should be monitoring you closely for heart disease.
How Big a Heart Disease Risk Predictor Is Erectile Dysfunction?
According to a 2005 American study that was published in the Journal of the American Medical Association, erectile dysfunction was “in the range of risk associated with current smoking or a family history of myocardial infarction” as far as predicting clinical cardiovascular events in men 55 and over. While erectile dysfunction doesn’t mean that a man will have a cardiovascular event, researchers concluded, “While a full cardiovascular evaluation is not necessary in response to findings of erectile dysfunction in asymptomatic patients, such findings should prompt diligent observation of at-risk men and reinforces the need for intervention for cardiovascular risk factors.”
A Recent Study in Australia
In 2013, Australian researchers reported on a study tracking 95,000 men aged 40 and up for up to three years. This study was different from previous ones in that it attempted to tease out the relative risk levels for men experiencing mild to severe erectile dysfunction. Researchers found that even mild erectile problems were associated with higher risk of heart problems, whether or not they had heart trouble in the past.
Ultimately, what this study did was suggest a consistent link between erectile dysfunction and heart disease, even when other variables like smoking, weight, alcohol consumption, etc. were controlled for. You can read the study in its entirety here.
What the Average Guy Should Take Away from This
First, if you think you have erectile dysfunction, don’t start with the self-blame. Since the introduction of the PDE-5 inhibitor drugs (Viagra, Levitra, Cialis, etc.) physicians and researchers have realized that erectile dysfunction is largely a problem of hydraulics and blood flow. While there are often psychological components to erectile dysfunction, such as a performance anxiety spiral, these negative cycles can often be broken by a combination of erectile dysfunction medication and emotional support.
You should also consider your known risk factors for heart disease and discuss them with your doctor. In many cases erectile dysfunction is an early clue to cardiovascular disease, and like so many other medical conditions, when cardiovascular disease is discovered and addressed early, treatments are easier and good results are more likely.
Perhaps the worst thing you can do if you experience erectile dysfunction is ignore it and hope it goes away. Not only could you deny yourself the rewards of a satisfying sex life, you could inadvertently allow an overall health problem to worsen. While it’s only natural to be reluctant to bring up erectile problems with your doctor, it is much less of a taboo topic than it was 20 years ago, and the typical doctor sees much more “personal” concerns in the course of an ordinary day. Erectile dysfunction can be successfully treated with oral medications, and if you’re a candidate for them, you could look forward to improvement in your sex life and your overall quality of life.
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