Erectile Dysfunction Can Be a Warning Sign for Heart Disease

Study finds even mild erection problems can increase risk of heart issues

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About one in five men over age 40 report moderate or severe erectile dysfunction, and according to a recent Australian study, these men could also have an increased risk of heart disease and early death.

The study isn’t the first to make the link between erectile dysfunction and heart disease, but it’s first to find the link among men with even mild erection problems.

The team of researchers, led by Emily Banks of Australian National University looked at hospital and death records of 95,000 men enrolled in the 45 and Up Study, one of the largest ongoing studies of healthy aging. The participants provided information about their lifestyles and health and were followed for two to three years. During the study period, 7,855 of the men were admitted to the hospital and 2,304 died.

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Those reporting erectile dysfunction had a higher risk of heart attack, heart failure, peripheral vascular disease and heart conduction issues. Overall, men with severe erectile dysfunction were 60% more likely to go to the hospital for coronary heart disease and twice as likely to die over a two to three year period, compared to men who did not have erection problems. But the study found that even among men with no history of heart disease, those who reported erection problems had a higher risk of being hospitalized for heart disease and premature death. And those with mild erectile dysfunction also had an increased risk of having heart trouble.

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The association held even when the scientists accounted for known risk factors for heart disease such as age, income, education, smoking, alcohol consumption, marital status, physical activity, weight, diabetes and current treatment for high blood pressure and high blood cholesterol.

“These results tell us that every man who is suffering from any degree of erectile dysfunction should be seeking medical assistance as early as possible and also insisting on a heart health check by their [doctor] at the same time,” said Dr. Rob Grenfell, director of the Heart Foundation, Australia’s heart disease organization, in a statement.

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The study authors stress that their study does not suggest that erectile dysfunction causes heart disease, only that the two conditions are linked, possibly because both involve problems with circulation. An erection requires a steady flow of blood to the penis, while heart disease occurs when vessels feeding the heart are blocked by plaques and ruptured clots.

“The reason why erectile dysfunction can serve as an early marker of silent cardiovascular risk—it has been termed “the canary in the trousers”—is not known exactly,” says Banks, who is scientific director of the 45 and Up Study. “Possibilities include the fact that the arteries of the penis are smaller and more sensitive to problems with the lining of the blood vessels than those of the heart, brain and limbs, so may show problems before a man experiences symptoms of overt cardiovascular disease.”

Whatever the mechanism, Banks says men shouldn’t simply ignore erection problems and continue to treat them with medications such as Viagra or Cialis. “Erectile dysfunction is extremely common in men with heart failure, and since a large proportion of heart failure is undiagnosed, particularly at its early stages, erectile dysfunction may serve as an early marker of occult heart failure that subsequently manifests itself and necessitates treatment in hospital,” she and her co-authors write.

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The study is published in the journal PLOS Medicine.