Sexual Health Q&A

What are the six modifiable risk factors for ED for men with ischemic heart disease?

Ischemic heart disease occurs when the blood supply to the heart is reduced due to atherosclerosis (hardening of the arteries). When plaque builds up on artery walls, it is more difficult for blood and oxygen to travel around the body and to the heart. As a result, a person can have chest pain and may eventually have a heart attack. Other terms for ischemic heart disease are coronary artery disease and coronary heart disease.

Men with ischemic heart disease often develop erectile dysfunction (ED), and the two conditions share many risk factors. Some of these risk factors are modifiable. In other words, men can take steps to control these factors and possibly reduce the likelihood of ED. However, research published in December 2015 found that many men are not aware of these risk factors.

The study identified six modifiable risk factors for ED. Many of them reduce the amount of blood flow to the penis. When a man is sexually aroused, his penis fills with blood, giving him the firm erection he needs for intercourse. When blood flow is impaired, he may have a weak erection or no erection at all.

Here are the risk factors:

Smoking. Chemicals from smoking can damage blood vessels and lead to atherosclerosis.

Overweight and obesity. For some men, obesity is linked to low testosterone, which can interfere with a man’s erections. Obesity also raises a man’s risk for heart disease and diabetes, which are common in men with ED.

High blood pressure (hypertension). High blood pressure is another condition that can cause atherosclerosis and restrict blood flow to the penis.  In addition, some medications used to treat hypertension are associated with ED.

Diabetes. ED is very common in diabetic men. Diabetes can lead to neuropathy (nerve damage), atherosclerosis, and low testosterone. Diabetic men may also experience venous leak. When this happens, veins cannot keep blood in the penis, resulting in a weak erection.

Hyperlipidemia (high levels of blood lipids). When lipids in the blood are too high, they can contribute to the buildup of plaque in the arteries and, ultimately, atherosclerosis.

Sedentary lifestyle. Exercise is important for good health on so many levels, including erections. It helps keep blood flowing smoothly throughout the body and to the penis. It also helps a man maintain a healthy weight.

As noted above, these risk factors are modifiable. There are things men can do to reduce their impact. Some actions include:

• Quitting smoking.
• Losing weight.
• Eating healthier food.
• Getting more exercise.

A man’s doctor can help him make such changes by referring him to a smoking cessation program, a nutritionist, a fitness expert, or any other appropriate specialist, if necessary.