Association of Erectile Dysfunction and Cardiovascular disease

Erectile dysfunction (ED) is a common problem affecting 15% of men in the age range of 40 to 50 years, 45% of men in their 60s, and 70% of men older than 70 years.

In addition to being a distressing condition itself, ED is thought to be a harbinger of cardiovascular disease (CVD) and mortality.

Common risk factors of Erectile Dysfunction and  Cardiovascular disease

ED and cardiovascular disease (CVD) share many common risk factors, including age, hypertension, diabetes, insulin resistance, smoking, increased body mass index (BMI), cholesterol, and lower high-density lipoprotein.

There is a growing body of evidence that ED is a sentinel marker of subclinical CVD and likely precedes symptomatic coronary artery disease (CAD). Studies have reported an increased prevalence of ED in patients with CAD compared with men without CAD as well as an increased risk of CVD in men with ED compared with men without ED.

Association of Erectile Dysfunction and Cardiovascular Disease

Although both Erectile Dysfunction(ED) and Cardiovascular Disease(CVD) share pathophysiological mechanisms and often coincide, there is limited agreement about whether Erectile Dysfunction(ED) should trigger further cardiovascular testing or improves the prediction of Cardiovascular Disease(CVD) beyond traditional risk factors. Indeed, the utilization of ED as a novel marker of Cardiovascular Disease(CVD) is under intense investigation. ED appears to be a marker of the severity of Cardiovascular Disease(CVD).

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Results from different studies

  1. In a study by Araujo et al. (2009), Erectile dysfunction (ED) was associated with an increased risk of Cardiovascular disease (CVD) mortality and all-cause mortality.
  2. In a large meta-analysis of 12 prospective cohort studies constituting a total of 36,744 subjects, Dong et al. (2011) demonstrated that men with ED have an increased RR of Cardiovascular disease (CVD) including Coronary Heart Disease (CHD), stroke, and all-cause mortality.
  3. One retrospective case-control study by Hodges et al. (2007), 55% of men had Erectile Dysfunction (ED) prior to presenting with acute coronary syndromes, compared with 43% of age-matched controls. The overall high prevalence of ED in controls leads to low specificity for predicting coronary events.
  4. A second retrospective study by Baumhakel and Bohm (2007) suggested ED preceded the onset of left ventricular systolic dysfunction by 3.04 ± 7.2 years, a finding limited by low numbers of respondents. While the findings of this study suggested that left ventricular systolic dysfunction worsened ED, the putative mechanistic connection between the two, endothelial dysfunction, was significantly weakened by the fact that nonischemic forms of ventricular dysfunction were not excluded. 
  5. In a well-designed long-term prospective trial of 1,709 with no prior CAD or diabetes, Araujo et al. (2009) examined whether ED predicts CVD beyond traditional risk factors such as Framingham Risk Score (FRS). Araujo et al.’s (2009) study reported ED was associated with Cardio Vascular Disease (CVD) incidence controlling for age, age, and traditional CVD risk factors, as well as age and Framingham Risk Score(FRS).

The Framingham Risk Score (FRS) was developed in 1998 to assess the 10-year risk of coronary heart disease (CHD) for individuals with different combinations of risk factors

Despite these significant findings, it was concluded that Erectile Dysfunction (ED) did not improve risk assessment above traditional methods (FRS), which clearly questioned the validity of utilizing Erectile Dysfunction (ED) as novel marker for predicting Coronary Artery Disease (CAD).

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 Many ED patients carry an intermediate risk of Coronary Artery Disease (CAD). Those patients should undergo additional noninvasive tests to “enrich” the prevalence of Coronary Artery Disease (CAD) and further stratify risk with the ultimate goal of identifying patients with subclinical Cardio Vascular Disease (CVD).

Conclusion

Despite the controversial role of ED in cardiovascular risk prediction and assessment, there may be a critical benefit in evaluating and managing cardiovascular risk in young men with moderate to severe ED and no known history of diabetes, Cardio Vascular Disease (CVD), or Coronary Artery Disease (CAD).

The urologist’s role is particularly critical in screening those high-risk patients (younger, moderate to severe ED, nondiabetics, no prior cardiovascular risks) and referring them to cardiology for further evaluation and assessment. The cardiologist is fundamental in determining and managing cardiovascular risk and disease. As ED is a disease of the endothelium and the vascular system and associated with an increase in cardiovascular risk, cardiologists must recognize the significance of ED and its potential sequelae.
Erectile Dysfunction(ED)can be treated with oral medications like viagra(Sildenafil), Tadalafil(Cialis) and Vardenafil. Contacting a physician will surely help in the case of Erectile Dysfunction (ED).“The ED Clinic” is offering a free consultation with the best doctors in the field. Men need to muster up the courage to seek professional help from a doctor or a qualified clinical sexologist. Just taking this step will get them on their way to recover not only their sex life but their relationship as well. They need not worry about their privacy as clinics like “The ED Clinic”  take full care to make sure all privacy details are just that- Private.

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