Erection problems may signal heart disease

WASHINGTON, Oct 11, 2005 (UPI via COMTEX) -- Men who have difficulty achieving an erection may be at high risk for clogged arteries and heart disease, a study released Tuesday indicates.

The study, which appears in the Oct. 18 issue of the Journal of the American College of Cardiology, found men with erectile dysfunction were more likely to have the beginning signs of atherosclerosis, or clogging and hardening of the arteries due to the buildup of plaque, than men without the disorder.

The findings held true even when the men did not exhibit other traditional risk factors of atherosclerosis, such as high cholesterol, smoking or diabetes.

Erectile dysfunction has been associated with hardened arteries, but it remains unclear whether it indicates a subclinical disease that may not have produced symptoms yet. The Italian researchers who conducted the study concluded erectile dysfunction may be an independent and early warning sign of cardiovascular problems.

"Erectile dysfunction should be part of a cardiovascular risk assessment," Emilio Chiurlia, the study's lead author and a professor at the University of Modena and Reggio Emilia in Modena, Italy, said in a statement.

"These patients should be considered at high risk for coronary artery disease and should have high priority for aggressive treatment," Chiurlia added.

The clinical definition of erectile dysfunction is the persistent inability to maintain an erection. An estimated 30 million men in the United States and 100 million men worldwide suffer from this disorder.

In the study, Chiurlia's team compared 70 men with an average age of 51 who had erectile dysfunction with 73 men of similar age and risk factors.

The men with erectile dysfunction had levels of C-reactive protein -- a predictor of future cardiovascular problems -- that were more than twice as high as the controls. The erectile-dysfunction group also was more likely to have impaired blood flow in the brachial artery (in the upper arm) and calcifications in the coronary artery as detected on multi-slice computed tomography scans.

Chiurlia said the reason atherosclerosis symptoms may first show up in the penis is because "the smaller penile arteries suffer obstruction from plaque burden earlier than the larger coronary arteries (and) hence erectile dysfunction may be symptomatic before a coronary event."

Further studies are needed to determine if men with erectile dysfunction will go on to develop heart disease and better determine how much of a risk factor the disorder might be for future cardiovascular problems, Chiurlia said.

Despite the limitations of the study, other experts agreed the findings indicate erectile dysfunction should be treated as a possible signal of the early stages of atherosclerosis.

"The present study ... lends strong support to the notion that erectile dysfunction may be an early warning sign of clinically-silent coronary artery disease," Dr. Renke Maas of the University-Hospital Hamburg-Eppendorf in Hamburg, Germany, said in a statement.

Dr. Jennifer Mieres, director of nuclear cardiology at North Shore University Hospital in Manhasset, N.Y., told United Press International men with erectile dysfunction should be further evaluated for cardiovascular problems. This would include a stress test of the heart during exercise to determine if there are significant blockages in the arteries and possibly a multi-slice computed tomography scan, said Mieres, who is also a spokeswoman for the American Heart Association.

If patients show signs of problems on those screenings, they should be started on aggressive therapy as if they had known heart disease, she said. This could include cholesterol-lowering drugs, aspirin, stopping smoking and controlling blood pressure or diabetes. Additionally, surgical procedures, such as putting in a stent or a bypass operation, may be warranted, Mieres said.

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