Erectile dysfunction: A red flag for heart disease

Erectile dysfunction – the inability to get and keep an erection firm enough for sex – can be an early warning sign of current or future heart problems. Likewise, if you have heart disease, getting the right treatment might help with erectile dysfunction.  

Cardiovascular disease (CVD) is not going away anytime soon.  This leading cause of death worldwide has had decades of research and money spent on the prevention and treatment of this condition which have been impactful but yet, still more work needs to be done. 

One of the best methods of reducing the incidence of any disease is prevention and early detection.  Some of the best interventions on reducing heart disease have been massive efforts on warning the public of the dangers of smoking, high blood pressure, diabetes, carrying excess body weight, lack of exercise and eating a poor diet.

 Now, a study published online in the journal Vascular Medicine titled “The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta- analysis,” focuses on a novel risk factor for cardiovascular disease which tends to get overlooked – erectile dysfunction (ED).

Erectile dysfunction and cardiovascular disease

The heart and a man’s penis have a common link when it comes to atherosclerosis, a disease that causes fat to build up in the body’s arteries. 

Fatty plaques narrow the inside diameter of an artery, slowing down blood flow.  The fatty plaque in coronary arteries can restrict blood flow to the heart muscles which could lead to a heart attack.  When this same plaque builds up in the penile arteries, it can cause erectile dysfunction.

Since these plaques grow slowly, symptoms may appear gradually over time.  For a man, this may mean they sometimes have ED and sometimes things work just fine.  Another symptom could be they notice it takes them longer to get an erection than usual and the erection they do get is more difficult to sustain.  Each of these symptoms are warning signs.  Once a man begins experiencing ED, he should see his primary care physician as soon as possible to look into the possibility of him having CVD.

Results from the study

The study which looked at the relationship between heart disease and ED aim was to establish ED as a simple and effective marker of underlying subclinical cardiovascular disease.  The researchers hypothesized that “measures of ED could be a simple effective cardiovascular disease risk stratification tool, particularly in young men who are less likely to undergo aggressive CVD risk assessment and management.”

A systematic review and meta-analysis of 28 studies looked at the link between ED and measures of early CVD.  What was found was a significant association of ED with impaired endothelial function which is a marker of the ability of blood vessels to relax that is an early indication of CVD.  Another finding was ED was associated with increased carotid intimal medical thickness which is another indicator of atherosclerosis. 

Conclusions from the study was that young men who have ED are at a greater risk of having CVD and would benefit from a more aggressive CVD assessment and management plan for these men having issues with ED.  Any young man, who mentions to his doctor that he is experiencing ED, should be considered at risk of heart disease. His doctor should take immediate steps to not place him in a low-risk category just because of his age but instead to look further by conducting tests to determine the extent of any heart disease found.

The main takeaway from the study was that any man, regardless of their age, who is having ED, should be aware that it can indicate a higher future risk of CVD.  Doctors should use this information to identify men by always asking them if they are experiencing ED and from there, use this information to intensity cardiovascular risk prevention strategies.