Erectile dysfunction can be strongly related to the development of CVD

In the first study of its kind, New England Research Institutes, Inc. (NERI) in collaboration with the Division of Cardiology, San Francisco General Hospital and the University of California, San Francisco tested whether erectile dysfunction (ED) can be used to reclassify patients according to their future risk of developing cardiovascular disease (CVD) beyond traditional risk factors (such as smoking, high blood pressure, high cholesterol, etc). Results of the 12-year research study are published in the January 26, 2010 issue of the Journal of the American College of Cardiology and show that ED may be a warning sign of a future cardiovascular event like heart attack, stroke, atherosclerosis, coronary artery bypass graft surgery, and congestive heart failure. However, while ED is significantly related to CVD independent of traditional risk factors, it does not improve the prediction of who will and will not develop CVD beyond these risk factors.

“Although the answer is no, this is not necessarily surprising given how strongly the Framingham risk score is related to CVD”

“This is an important study because it is the first to explicitly test whether ED can predict the future development of CVD beyond a predictive tool called the Framingham risk score,” said Andre Araujo, PhD, Director of Epidemiology at NERI and lead researcher of the study. “Although the answer is no, this is not necessarily surprising given how strongly the Framingham risk score is related to CVD,” said Araujo. “Our data indicate that ED is as strongly related to the development of CVD as the Framingham risk score.”

The study followed 1,057 men (ages 40-70) from the Massachusetts Male Aging Study (MMAS) – a prospective observational study of aging, health, and endocrine and sexual function – over an average of 12 years. These men were free of diabetes and CVD at the start of their study participation. However, during the follow-up years, 261 new cases of CVD occurred. ED predicted the development of CVD, independent of age, traditional risk factors, and Framingham risk score. Men with ED showed a 40 percent higher risk of developing CVD compared to men without ED.

According to data from the National Health and Nutrition Examination Survey, ED affects approximately 18 million men aged 20 years or older in the US. ED and CVD share a number of risk factors like smoking, obesity, and high blood pressure. Physiologically, the link between ED and CVD can be explained by the fact that the penis and the heart are both vascular organs that are subject to atherosclerosis or thickening of the arteries. Since atherosclerosis affects the entire body, the small arteries in the penis can become blocked sooner than the larger arteries in the heart. Blocked arteries reduce blood flow which can result in a reduced ability to have an erection.

“Even though the study showed that ED does not improve risk prediction beyond the Framingham risk score, an ED assessment can be done at very low cost and presents no risk to patients (unlike other novel CVD screening tests),” said Araujo. “Previous work from our study shows that a simple single question ED measure correlates well with an independent physician’s assessment. Therefore, health professionals should consider asking about ED in their older male patients,” continued Araujo. “Also, when a patient presents with ED, health professionals should work the patient up for CVD as there may be a window of opportunity for men to improve their health before a CVD event occurs.”