Impotence may be early warning of heart disease

November 09, 1999

ATLANTA, Nov. 10 -- Erectile dysfunction may be an early warning sign of heart disease, according to research being presented today 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 Marc R. Pritzker, M.D., 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 a 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. In the eight other men who had positive exercise tests, further testing showed that either heart disease was not present or that angiography was not warranted for the minimal heart disease that was found.
Media advisory: Dr. Pritzker can be reached at 612-863-3900 or by email at or

American Heart Association

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to