Men suffering from impotence
should be screened for cardiovascular disease because
it could be an early sign of the illness, Italian
researchers said.
They believe erectile dysfunction (ED) could be a
"sentinel of the heart," enabling doctors to detect
heart disease before symptoms occur.
"A strict medical surveillance program should be
mandatory in patients with ED, multiple risk factors
and no clinical artery disease," said Dr Piero Montorsi
of the Institute of Cardiology at the University of
Milan.
In a study of almost 300 men who suffered from impotence
and clogged arteries, 93 percent reported symptoms
of ED between one to three years before experiencing
angina -- chest pains and discomfort.
"Many patients with ED and multiple risk factors
(for cardiovascular disease) are at a higher risk
of developing, sooner or later, a coronary acute event,"
Montorsi stated.
He and his team suggested that clogged arteries also
have an impact on penile circulation. ED may develop
earlier than heart disease because the penile artery
has a smaller diameter than coronary arteries.
"This is probably the main reason why ED comes before
coronary artery disease," said Montorsi whose findings
are reported online by the European Heart Journal.
The researchers also discovered that the number of
cases of erectile dysfunction was lower in men who
had a heart attack involving one clogged blood vessel
and higher in patients with many clogged arteries
or chronic coronary syndrome (CCS).
"Age, multi-vessel coronary involvement, and CCS
were independent predictors of ED," Montorsi said.
Coronary heart disease, a major killer in industrialized
countries, occurs when there is a build up of plaque
which clogs up the arteries and restricts blood flow.
High blood pressure, raised cholesterol levels, smoking,
lack of exercise and diabetes are risk factors.
Cases of erectile dysfunction increase with age.
About 5 percent of 40-year-old men and up to 25 percent
of 65 year-olds experience ED. It can be caused by
an illness or injury that affects the nerves or blood
flow or the side effects of drugs.
"All men with ED and no cardiac symptoms need a detailed
cardiac assessment, blood pressure measurement, fasting
lipid profile and glucose, as well as lifestyle advice
regarding weight and exercise," said Dr Graham Jackson,
a cardiologist at Guy's and St Thomas' NHS Foundation
Trust in London, in a statement.
