Researchers urge physicians to ask younger men about erectile dysfunction symptoms

July 25, 2012, Lifespan

Although erectile dysfunction (ED) has been shown to be an early warning sign for heart disease, some physicians – and patients – still think of it as just as a natural part of "old age." But now an international team of researchers, led by physicians at The Miriam Hospital, say it's time to expand ED symptom screening to include younger and middle-aged men.

In an article appearing in the July issue of the American Heart Journal, they encourage to inquire about ED symptoms in over the age of 30 who have cardiovascular risk factors, such as smoking, obesity or family history, and in all men with type 2 diabetes.

As many as 30 million American men suffer from ED, or the inability to maintain an erection sufficient for sexual intercourse. ED and share a common cause: narrowing of the arteries, resulting in reduced or obstructed blood flow to the organs. They also share similar risk factors, including smoking, diabetes, obesity and high blood pressure. Because the penile arteries are just a fraction smaller than the arteries supplying blood to the heart, symptoms of conditions that can narrow the arteries, such as arteriosclerosis, are likely to present first in the form of erection problems. That's why it is also believed that the more severe the ED, the greater the risk of heart disease-related events, such as heart attack and stroke.

"Erectile dysfunction represents an important first step toward heart disease detection and reduction, yet many health care providers and patients assume it's just a sign of old age, so it may not be something that comes up during an annual physical with a younger man who doesn't fit the ED 'stereotype,'" says lead author Martin Miner, M.D., chief of family medicine and co-director of the Men's Health Center at The Miriam Hospital.

"That's why we urge physicians to discuss sexual function with the majority of their male patients – including diabetic men of all ages and men over the age of thirty with some of the traditional heart disease risk factors, like smoking or a family history," he adds.

Although not all men with ED are at increased risk for cardiovascular disease, Miner says it is the physician's responsibility to make that determination based on aggressive workup and testing. If the patient is found to be at risk, the patient can then receive intensive risk factor management.

Miner and colleagues conducted a literature review of 40 studies that suggest ED is a significant predictor for cardiovascular disease in two populations: men under the age of 60 and men with diabetes. Their analysis supports several widely-held theories, including the role of ED as a significant red flag for cardiovascular disease in younger and middle-aged men.

For example, in the Mayo Clinic's Olmsted County Study, a large, epidemiological study cohort of men from Olmsted County, Minnesota, men 40 to 49 years old with ED were twice as likely to develop coronary artery disease as those who did not have ED. However, ED had less predictive value for men 70 years and older.

Several studies, including a large analysis of more than 6,300 men enrolled in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation) trial, suggest ED is a particularly powerful indicator of cardiovascular disease in diabetic men as well, prompting researchers to call for ED symptom screening in all men with type 2 diabetes.

Miner points out early identification of men at risk for cardiovascular disease has the potential to lower health care costs and improve outcomes.

"There may be a 'window of curability' in which we can intervene early and stop the progression of heart disease," he says. "Also, it may be possible to someday use erectile function as a measurement to tell us if preventive interventions for are working."

Explore further: Treatment of CV risk factors appears to improve sexual function in men with erectile dysfunction

Related Stories

Treatment of CV risk factors appears to improve sexual function in men with erectile dysfunction

September 12, 2011
Lifestyle modifications and pharmaceutical treatment of risk factors for cardiovascular disease are associated with improvement in sexual function among men with erectile dysfunction (ED), according to a meta-analysis posted ...

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.