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Erectile dysfunction may signal early atherosclerosis
October 12, 2005Study of otherwise healthy men reveals indications of coronary artery disease
(BETHESDA, MD) - Erectile dysfunction may be a sign that coronary artery disease is developing, even in men without typical risk factors, according to a new study in the Oct. 18, 2005, issue of the Journal of the American College of Cardiology.
"We think that erectile dysfunction represents the 'tip of the iceberg' of a systemic vascular disorder; thus potentially preceding severe cardiovascular events. Erectile dysfunction should be part of a cardiovascular risk assessment. These patients should be considered at high risk for coronary artery disease and should have high priority for aggressive treatment," said Emilio Chiurlia, Ph.D. from the University of Modena and Reggio Emilia in Modena, Italy.
The researchers studied 70 men with erectile dysfunction and 73 control subjects who were of similar age and race (all Caucasian), and had similar coronary risk factor scores according to estimates published by the National Cholesterol Education Panel III. None of the men had symptoms of coronary atherosclerosis.
The men with erectile dysfunction had higher levels of C-reactive protein (an emerging coronary risk factor), they were more likely to have abnormal blood vessel responses to changes in blood flow (as measured by flow mediated dilation), and more of them had coronary artery calcifications detected on coronary CT scans.
"When a man is diagnosed with erectile dysfunction, clinicians should be aware that erectile dysfunction would represent an early clinical manifestation of a diffuse subclinical vascular disease and coronary artery disease is the most important problem that needs to be investigated. The smaller penile arteries suffer obstruction from plaque burden earlier than the larger coronary arteries hence erectile dysfunction may be symptomatic before a coronary event," Dr. Chiurlia said.
Dr. Chiurlia noted that this study involved only a small number of men and did not follow them over time to see which ones actually developed heart disease.
"We need prospective studies addressing the precise role of erectile dysfunction as a marker of cardiovascular disease," he said.
While awaiting the results of such future studies, he said erectile dysfunction should raise suspicions about early atherosclerosis, even in men who would not otherwise be considered at high risk.
"In our opinion, erectile dysfunction should be considered, like diabetes, a 'cardiovascular equivalent,'" Dr. Chiurlia said.
Renke Maas, M.D., from the University-Hospital Hamburg-Eppendorf in Hamburg, Germany, who was not connected with this research, agreed with the main conclusion of the study.
"The present study by Chiurlia et al. lends strong support to the notion that erectile dysfunction may be an early warning sign of clinically-silent coronary artery disease. Despite limitations set by sample size and the cross-sectional study design with a long list of exclusion criteria, it is a strength of the present work that it assesses major aspects connecting erectile dysfunction and more generalized vascular disease in one study," Dr. Maas said.
Paul Schoenhagen, M.D., from the Cleveland Clinic Foundation in Cleveland, Ohio, who also was not connected with the research, said it provides evidence of related problems in two different regions of the arterial tree.
"These results demonstrate the systemic nature of atherosclerosis and the relationship to an inflammatory process of the vessel wall. This understanding of atherosclerosis increasingly allows early interventions aimed at the prevention of disease complications," Dr. Schoenhagen said.
American College of Cardiology
The researchers studied 70 men with erectile dysfunction and 73 control subjects who were of similar age and race (all Caucasian), and had similar coronary risk factor scores according to estimates published by the National Cholesterol Education Panel III. None of the men had symptoms of coronary atherosclerosis.
The men with erectile dysfunction had higher levels of C-reactive protein (an emerging coronary risk factor), they were more likely to have abnormal blood vessel responses to changes in blood flow (as measured by flow mediated dilation), and more of them had coronary artery calcifications detected on coronary CT scans.
"When a man is diagnosed with erectile dysfunction, clinicians should be aware that erectile dysfunction would represent an early clinical manifestation of a diffuse subclinical vascular disease and coronary artery disease is the most important problem that needs to be investigated. The smaller penile arteries suffer obstruction from plaque burden earlier than the larger coronary arteries hence erectile dysfunction may be symptomatic before a coronary event," Dr. Chiurlia said.
Dr. Chiurlia noted that this study involved only a small number of men and did not follow them over time to see which ones actually developed heart disease.
"We need prospective studies addressing the precise role of erectile dysfunction as a marker of cardiovascular disease," he said.
While awaiting the results of such future studies, he said erectile dysfunction should raise suspicions about early atherosclerosis, even in men who would not otherwise be considered at high risk.
"In our opinion, erectile dysfunction should be considered, like diabetes, a 'cardiovascular equivalent,'" Dr. Chiurlia said.
Renke Maas, M.D., from the University-Hospital Hamburg-Eppendorf in Hamburg, Germany, who was not connected with this research, agreed with the main conclusion of the study.
"The present study by Chiurlia et al. lends strong support to the notion that erectile dysfunction may be an early warning sign of clinically-silent coronary artery disease. Despite limitations set by sample size and the cross-sectional study design with a long list of exclusion criteria, it is a strength of the present work that it assesses major aspects connecting erectile dysfunction and more generalized vascular disease in one study," Dr. Maas said.
Paul Schoenhagen, M.D., from the Cleveland Clinic Foundation in Cleveland, Ohio, who also was not connected with the research, said it provides evidence of related problems in two different regions of the arterial tree.
"These results demonstrate the systemic nature of atherosclerosis and the relationship to an inflammatory process of the vessel wall. This understanding of atherosclerosis increasingly allows early interventions aimed at the prevention of disease complications," Dr. Schoenhagen said.
American College of Cardiology
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Pivotal study for PSD502 -- the first potential treatment for premature ejaculation
At the annual meeting of the Sexual Medicine Society of North America (SMSNA), Inc. in San Diego, Sciele Pharma, Inc., a Shionogi Company and Plethora Solutions Limited, a wholly owned subsidiary of Plethora Solutions Holdings PLC ("Plethora" - AIM:PLE)., today presented data from its second positive pivotal study of PSD502 for the treatment of premature ejaculation (PE).
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Workplace BPA exposure increases risk of male sexual dysfunction
High levels of workplace exposure to Bisphenol-A may increase the risk of reduced sexual function in men, according to a Kaiser Permanente study appearing in the journal Human Reproduction, published by Oxford Journals.
Study points to new uses, unexpected side effects of already-existing drugs
Scientists at the University of North Carolina at Chapel Hill School of Medicine and the University of California, San Francisco have developed and experimentally tested a technique to predict new target diseases for existing drugs.
Drug shows promise in treating dangerous complication of erectile disorder
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BUSM researchers propose a relationship between androgen deficiency and cardiovascular disease
Researchers from Boston University School of Medicine (BUSM) in collaboration with researchers from Lahey Clinic Northshore, Peabody, Mass., believe that androgen deficiency might be the underlying cause for a variety of common clinical conditions, including diabetes, erectile dysfunction, metabolic syndrome and cardiovascular disease (CVD).
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Current research suggests that the inflammatory molecule TNF-α may contribute to delayed bone fracture healing in diabetics.
Topical erectile dysfunction therapy shows promise
An innovative drug-delivery system - nanoparticles encapsulating nitric oxide or prescription drugs - shows promise for topical treatment of erectile dysfunction (ED), according to a new study by scientists at Albert Einstein College of Medicine of Yeshiva University.
Dr. Ronald Lewis Couples' treatment for sexual problems on the agenda for sexual medicine experts
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