ED May Herald Coronary Heart Disease
Erectile dysfunction in men under 50 predicts a nearly twofold higher risk of a cardiac event.
“We found that there is a strong association between erectile dysfunction and heart disease, and that erectile dysfunction often precedes heart disease,” said study investigator Brant A. Inman, MD, a urologic oncology fellow at the Mayo Clinic in
Men with ED who are younger than 50 years have a roughly twofold greater risk of having a heart attack, Dr. Inman said. The presence of ED in men older than 70 years, however, has little impact on coronary risk.
Men younger than 50 who are diagnosed with ED should be evaluated thoroughly for CHD risk factors, such as high BP and cholesterol, Dr. Inman said.
He and his colleagues prospectively studied 2,447 men who were part of the Olmsted County Study and aged 40-79 years on January 1, 1990. Each man had biennial urologic screening since that year. In 1996, researchers administered the Brief Male Sexual Function Inventory (BMSFI), which included 11 questions and covered five domains (libido, erection, ejaculation, sexual problem assessment, and sexual satisfaction). The researchers also examined the community medical records of the men to determine the occurrence of incident CHD between 1979 and 2006.
The investigators, who presented their findings here at the American Urological Association annual meeting, found that 19% of men reported having ED in 1996, and 11% had already experienced a coronary event. When the patients were followed over the 10-year time period from 1996 to 2006, those who initially had reported having ED were more than twice as likely to experience a CHD event as patients without ED.
“We found that in men who did not have erectile dysfunction, there was roughly a 10% cumulative incidence of a new heart attack or other coronary event, whereas in men who had erectile dysfunction it was roughly 20%,” Dr. Inman told Renal & Urology News.
Heart disease and ED are probably manifestations of the same disease, he explained. Sometimes the two conditions show up at the same time and sometimes one comes before the other, he said. Young men with ED may be an ideal group in which to examine whether interventions such as statin therapy or BP treatments affect future CHD risk, he said.
Dr. Inman pointed out that 60% of the men in the study were either current or past smokers and 80% were overweight. Addressing these issues could have a positive impact on erectile function and CHD risk, he said.