ATLANTA, Nov 10 (Reuters Health) -- The introduction of the impotence drug Viagra has had an unexpected bonus -- among men seeking treatment for erectile dysfunction, physicians are now finding those who are also at high risk for heart disease.
Finding these men early, even before they have had symptoms of heart disease such as chest pain, gives doctors the opportunity to start them on therapies and counsel them on lifestyle changes aimed at preventing heart attack or sudden death due to heart disease.
The introduction of Viagra (sildenafil) and other treatments for impotence is giving cardiologists their first chance to practice prevention in this population at high risk for heart disease, Dr. Marc R. Pritzker of the Minneapolis Heart Institute Foundation said here at the 72nd Scientific Sessions of the American Heart Association.
This group of patients traditionally does not seek medical care until symptoms of heart disease such as chest pain are present, he notes.
"If the erectile dysfunction is pegged by the physician to be vascular in origin (rather than due to depression, drug therapy, spinal cord injury or other nonvascular cause), then you should go on and check for vascular disease," Pritzker advised heart specialists. "If there is vascular disease in one area (of the body), then there is a much higher risk of having vascular disease in other areas."
Pritzker and colleagues studied 50 men between the ages of 40 and 65 whose primary complaint was erectile dysfunction. In 40 of the 50 cases, these men had multiple risk factors for cardiovascular disease: 40 smoked, 35 had cholesterol levels above 220 mg/dl, 24 had hypertension, 10 had diabetes, 32 had a family history of heart disease, and 38 had sedentary lifestyles.
The Minneapolis team performed coronary angiography, an imaging study that outlines the heart arteries, in 20 of the subjects and found significant blockage of one or more arteries in 6 men and various degrees of obstruction in one or more vessels in the other 14 men.
"The penile arteries are small and may manifest signs of vascular disease early," Pritzker notes. He said that before recommending any treatment for impotence in a man with erectile dysfunction of vascular origin, he advises physicians to test for cardiac disease.
