Erectile dysfunction (ED) may precede a cardiovascular event by two to five years, according to a report in the July issue of Sexual Medicine Reviews.
Dr. Graham Jackson, a consultant cardiologist at London Bridge Hospital, London and BMI Shirley Oaks Hospital in Croydon, Surrey examined literature on the relationship between ED and coronary artery disease (CAD).
The link between the two conditions, he explained, could be found in the artery size hypothesis. Artery sizes in the human body vary widely, from tiny penile arteries (1-2 mm) to larger femoral arteries (6-8 mm) in the thighs. Since penile arteries are smaller and have more surface area, CAD may have a more significant effect there.
This may explain why ED often occurs before cardiovascular disease is detected. Penile arteries tend to become blocked before their larger counterparts.
Supporting studies have shown that erectile dysfunction is common in men with coronary artery disease. In one study, 49% of 300 patients with coronary artery disease had ED. Sixty-seven percent of the men with ED had those symptoms before their CAD symptoms developed.
In another study, researchers looked at the ED incidence among 260 men with type 2 diabetes. Almost 34% of the men with asymptomatic CAD had ED compared to about 5% of the men without CAD.
The timing of erectile dysfunction in relation to CAD is notable. Men may have ED symptoms up to five years before a cardiovascular event. In one supporting study, 93% of men with a chronic coronary syndrome had ED symptoms before they developed angina pectoris. The mean time frame between the two conditions was 24 months.
“Importantly, given that men with ED may be at cardiovascular risk, this long lead time provides an early opportunity for cardiovascular risk reduction,” Dr. Jackson wrote.
ED may be an “especially powerful predictor” of cardiovascular problems in men between the ages of 30 and 60. For men over age 70, the link between ED and coronary artery disease becomes weaker.
Studies have shown that men with ED are at increased risk for cardiovascular disease, myocardial infarction, stroke, and all-cause mortality.
“ED should therefore be incorporated into routine clinical practice as a diagnosis needing treatment as well as a diagnosis that could trigger an aggressive CVD risk reduction strategy,” Dr. Jackson noted.
London Bridge Hospital
“Dr. Graham Jackson”
Sexual Medicine Reviews
Jackson, Graham, FRCP, FESC, FACC
“Prediction of Coronary Artery Disease by Erectile Function Status: Evidence-Based Data”
(Full-text. First published online: June 11, 2013)