Erectile dysfunction may be an early warning sign of heart disease, according to a new study. Physicians should determine the cause of a man's erectile dysfunction and recommend additional evaluation in cases where it may be the result of diseased blood vessels, according to researcher Dr. Marc R. Pritzker of the Minneapolis Heart Institute Foundation.
"Erectile dysfunction could be called a 'penile stress test,' and may be another way for detecting diseased blood vessels in much the same way that the exercise stress test, which measures electrical signals from the heart, is used to detect diseased blood vessels of the heart," said Pritzker.
The study found that atherosclerosis detected in one set of blood vessels markedly increases the chances of having this form of blood vessel disease in other areas of the body including the heart, brain, legs and kidneys. Because the blood vessels that supply the penis are narrower than arteries in other areas of the body, atherosclerosis -- the buildup of plaque in the arteries that can cause heart attack and stroke -- may manifest itself as erectile dysfunction before the disease becomes apparent in other arteries.
The research was presented Wednesday at the American Heart Association Scientific Sessions in Atlanta.
"This provides a wonderful opportunity for strong preventative programs that could reduce the risk of heart attacks and strokes," said Pritzker.
The study reviewed the histories and test results of 50 men with erectile dysfunction who had sought prescriptions for the impotence drug Viagra. Although none of the men had symptoms of heart disease, 20 of them, or 40 percent, were found to have significant blockages in heart arteries, which are associated with chest pain and an increased risk of heart attack.
The 20 men subsequently underwent angiography: Six of the 20 had blockages in all three major heart arteries; seven had two arteries that showed narrowing; and one artery was blocked in the remaining seven men. In the eight other men who had positive test results, further testing showed that heart disease was not present or that angiography was not warranted for the minimal heart disease that was found.
"Our population of patients was a very select group," said Pritzker. "We do not wish to suggest that heart disease is behind every case of erectile dysfunction. However, a man having regular sexual activity who experiences a consistent change in erectile function may be demonstrating signs of atherosclerosis, where arteries become clogged and the heart muscle does not receive enough blood. As we become more thorough in our questioning of patients, it is not uncommon to hear that erectile dysfunction preceded the onset of heart disease by a year or more. Thus, erectile dysfunction may be an early warning sign of the potential for heart problems."
As much as half of cases of erectile dysfunction are the result of blood vessel disease, along with use of prescription drugs such as heart or high blood pressure medications, pelvic injury, depression, drug dependency, degenerative diseases such as multiple sclerosis, and even fatigue and stress. Erectile dysfunction can also be the result of psychological factors, according to Pritzker.
"We now have another opportunity to look for heart disease, make a diagnosis, and offer appropriate prevention and, if necessary, treatment to men in an age group at risk for vascular disease, but who often don't visit a physician for routine check-ups," said Pritzker.
