Experts Call for Urgent Action to Tackle Strong
Links Between Impotence and Heart Disease
Heart
disease risk increases 27% in men aged 60 to 69 but
all men experiencing impotence should undergo
thorough medical assessments
May 19, 2010 - International experts are calling
for all men experiencing impotence to undergo thorough medical
assessments, after an extensive review showed that a significant
proportion of men with erectile dysfunction (ED), which most often
inflicts senior citizens, exhibit early signs of
coronary artery disease (CAD). Interestingly, the risk was not as clear
for senior citizens over age 70 as for younger men.
A paper published in the June issue of IJCP, the
International Journal of Clinical Practice, shows that men with ED
will often develop coronary symptoms within two to three years of
impotence and actually experience a cardiovascular event, such as a
heart attack, within three to five years.
The authors stress that it is vital that clinicians
stabilize cardiovascular function and control any symptoms before even
considering initiating any ED therapy.
Dr Graham Jackson, a London-based cardiologist and
Chair of the Sexual Advice Association, teamed up with 11 experts from
all over the UK, Italy, Greece and the USA to analyze the findings of
more than a hundred studies on the links between ED and CAD.
They concluded that:
>> ED in otherwise healthy
men and those with type 2 diabetes may be associated with early
subclinical signs of CAD, including reduced blood flow and
calcification of the arteries.
>> Men with ED generally
exhibit more severe CAD and dysfunction in the left ventricle of the
heart than those without ED and the severity of the ED may also be
correlated with the severity of the CAD.
>> In around two-thirds of
men, CAD is preceded by ED. The association in younger men aged
between 40 and 69 is much clearer than in men over 70.
>> ED is associated with an
increase in all-cause mortality, primarily through its associated
with CAD.
A
number of studies have sought to quantify the increased risk.
>> One study found that men
aged between 30 and 39 with moderate to severe ED have a 14 per cent
higher risk of developing CAD within ten years than men without CAD
(4.9 per cent and 4.3 per cent respectively). This figure rose to 27
per cent in men aged 60 to 69 (21.1 per cent and 16.6 per cent
respectively).
>> Other studies suggest
that the increased risk can range from 30 to 60 per cent, compared
with a 40 per cent increase for a man with a family history of heart
attacks and a 10 per cent increase for a 20mg/dl rise in serum
cholesterol concentration.
The authors suggest that the link between the two
conditions could be due to atherosclerosis, a systemic condition where
plaque builds up inside the arteries, leading to restricted blood flow.
"It has been suggested that because the arteries
supplying the penis are smaller than those supplying the heart, they
will be affected by reduced blood flow - a major cause of ED - before
the symptoms of CAD develop" explains Dr Jackson.
"This theory may underpin the findings that men
with ED seldom report overt symptoms of CAD, but those with CAD often
report pre-existing ED symptoms."
The paper goes on to discuss prevention strategies
and how patients should be assessed, tested, managed and followed up.
Special guidance is also provided on dealing with patients with
diabetes.
"The evidence supporting the relationship between
ED and cardiovascular disease has continued to increase over recent
years and yet recognition of the association remains limited among
healthcare professionals and the general public" concludes Dr Jackson.
"Clinicians who specialise in managing ED support
the evidence that ED is a critical predictor of cardiovascular disease
and that men with ED therefore face an increased risk."
The authors, who have extensive experience of
cardiovascular and sexual medicine, hope that the evidence and consensus
detailed in their IJCP paper will encourage greater international
interest and research on the association between ED and CAD.
"Recognising the relationship between ED and CAD
will improve and save lives" says Dr Jackson. "That is why wider
awareness of the links is essential."
Notes:
IJCP, the International Journal of Clinical
Practice was established in 1946 and is published by Blackwell
Publishing Ltd, part of the international Blackwell Publishing group.
www.ijcp.orgwww.twitter.com/IJCPeditors
Wiley-Blackwell is the international scientific,
technical, medical and scholarly publishing business of John Wiley &
Sons. For more information, please visit
www.wileyblackwell.com or
www.interscience.wiley.com
May 19, 2010 - International experts are calling
for all men experiencing impotence to undergo thorough medical
assessments, after an extensive review showed that a significant
proportion of men with erectile dysfunction (ED), which most often
inflicts senior citizens, exhibit early signs of
coronary artery disease (CAD). Interestingly, the risk was not as clear
for senior citizens over age 70 as for younger men.
