Re: Erectile Dysfunction ... Early Warning for Heart Disease?

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AHA: Impotence May Be Early Warning Of Heart Disease

ATLANTA, GA -- November 10, 1999 -- Erectile dysfunction may be an early

warning sign of heart disease, according to research being presented at the

American Heart Association Scientific Sessions. Therefore, physicians should

determine the cause of a man's erectile dysfunction and recommend additional

evaluation in cases where it may be the result of diseased blood vessels,

says the researcher.

Erectile dysfunction is defined as an inability to achieve or maintain an

erection. " Erectile dysfunction could be called a 'penile stress test,' and

may be another way for detecting diseased blood vessels in much the same way

that the exercise stress test, which measures electrical signals from the

heart, is used to detect diseased blood vessels of the heart, " says Dr. Marc

R. Pritzker, of the Minneapolis Heart Institute Foundation.

" We now understand that atherosclerosis detected in one set of blood vessels

markedly increases the chances of having this form of blood vessel disease

in other areas of the body including the heart, brain, legs and kidneys.

Because the blood vessels that supply the penis are narrower than arteries

in other areas of the body, atherosclerosis -- the disease process that

leads to heart attacks and strokes -- may manifest itself as erectile

dysfunction before the disease becomes apparent in other arteries. This

provides a wonderful opportunity for strong preventive programs that could

reduce the risk of heart attacks and strokes, " Pritzker says.

Pritzker reviewed the histories and test results of 50 men with erectile

dysfunction who had sought prescriptions for Viagra (a drug to treat

impotence) and in turn were referred by their physicians for further

evaluation. Although none of the men had symptoms of heart disease, 20 of

them, or 40 percent, were found to have significant blockages in heart

arteries which are associated with chest pain and an increased risk of heart

attack.

" Our population of patients was a very select group. We do not wish to

suggest that heart disease is behind every case of erectile dysfunction.

However, a man having regular sexual activity who experiences a consistent

change in erectile function may be demonstrating signs of atherosclerosis

where arteries become clogged and the heart muscle does not receive enough

blood. As we become more thorough in our questioning of patients, it is not

uncommon to hear that erectile dysfunction preceded the onset of heart

disease by a year or more. Thus erectile dysfunction may be an early warning

sign of the potential for heart problems. "

Pritzker adds that anywhere from 30 to 50 percent of cases of erectile

dysfunction are the result of blood vessel disease. Other possible causes

include use of prescription drugs such as heart or high blood pressure

medications, pelvic injury, depression, drug dependency, degenerative

diseases such as multiple sclerosis, and even fatigue and stress. Erectile

dysfunction can also be the result of psychological factors, he says.

" The experience to date with Viagra has shown it to be safe for patients

with most forms of cardiovascular disease when the patients are

appropriately counseled to avoid the use of nitroglycerin or

nitroglycerin-like drugs and follow reasonable guidelines regarding physical

exertion, " Pritzker says.

" The introduction of new treatments for erectile dysfunction offered options

that were effective and easy. The openness that followed has significant

public health implications, " says Pritzker. " We now have another opportunity

to look for heart disease, make a diagnosis, and offer appropriate

prevention and, if necessary, treatment to men in an age group at risk for

vascular disease, but who often don't visit a physician for routine

check-ups. Only 15 of the 50 study participants had seen a physician within

the two years before seeking treatment for erectile dysfunction.

" The heart disease found in the study participants was treatable and, in

many cases, the men's erectile dysfunction went away when they quit smoking

or got their cholesterol levels under control, " he says.

None of the patients in Pritzker's study had symptoms of heart disease but

40 out of 50 had at least one risk factor for heart disease including

cigarette smoking, elevated total cholesterol levels, high blood pressure,

diabetes or a family history of heart disease. Treadmill exercise testing

found signs of heart disease in 28 of the 50 men.

Twenty of the men subsequently underwent angiography where a radioactive dye

is injected into the heart arteries and then an X-ray is taken in order to

detect blockages. Six of the 20 had blockages in all three major heart

arteries, seven had two arteries that showed narrowing and one artery was

blocked in the remaining seven men. The eight other men had positive

exercise tests but further testing showed that either heart disease was not

present or that angiography was not warranted for the minimal heart disease

that was found.