~ Erectile Dysfunction (Impotence) - An Early Sign of Heart Disease

Birmingham Post, 07-31-06

Impotence may provide an effective warning sign of heart disease and diabetes in slim men, a new study suggests.

Early signs of the conditions are often missed in men of normal weight who appear outwardly healthy.

But what happens in the bedroom may point the way to undiagnosed problems, researchers have found.

They believe erectile dysfunction could be used to alert doctors who may be unaware their patients are at risk.

A team led by Dr Varant Kupelian, from the New England Research Institutes in Massachusetts, US, analysed data collected from 928 men over a 15-year period.

The researchers looked for signs of metabolic syndrome (MetS) which can lead to heart disease and diabetes. Symptoms include raised cholesterol, high blood sugar, high blood pressure and obesity.

In men with a body mass index (BMI) of less than 25, those with erectile dysfunction were twice as likely to develop MetS as those without the problem.

BMI is a measurement that relates height and weight. A BMI of 19 to 25 is considered normal while people who score 30 and above are categorised as clinically obese.

In overweight or obese men, it is easier to see evidence of metabolic syndrome.

Blood vessels in the penis are narrower than in other parts of the body and more susceptible to damage.

It is thought this might make the penis a good barometer for heart disease.

"There is emerging evidence that ED is not simply a secondary complication of CVD (cardiovascular disease) but an early marker for cardiovascular risk and sub-clinical systemic vascular disease," the researchers wrote in the Journal of Urology.

Dr Graham Jackson, a cardiologist at St Thomas' Hospital, London, and a leading expert in erectile dysfunction and heart disease, said: "Obesity is an excellent guide to identifying men at risk of heart disease.

"But if the man is of normal weight and looks perfectly healthy, some doctors may not think of heart disease. In this instance, erectile dysfunction can be a better warning signal than a large 'beer' belly.

"Sensitive questioning about sexual function can help identify 'at-risk' men, many of whom would otherwise slip through the net, and be left exposed to a future heart attack or the onset of diabetes."

Dr Ian Banks, President of the Men's Health Forum said: "ED can be a devastating condition in its own right, but for it to be a marker of potentially deadly heart problems or diabetes makes it too important to ignore.

"Too many men ignore the problem or seek cures on the internet. We need to encourage men to come forward so that all the underlying problems can be diagnosed. GPs can play their part too. Asking about sex might be only way to get through to these men before it's too late."

In 2001, Dr Jackson, working with colleague Dr Peter O'Kane, reported two case studies where ED was present before any symptoms of coronary artery disease.

One patient became impotent two months before suffering a heart attack. ED affecting the other man prompted investigations which eventually led to the discovery of diseased arteries. An Italian team led by Dr Piero Montorsi, from the Institute of Cardiology in Milan, found that impotence preceded symptoms of heart pain in two thirds of men with artery disease.

'If the man is of normal weight and looks perfectly healthy, some doctors may not think of heart disease. In this instance, erectile dysfunction can be a better warning signal than a large beer belly'

Cardiologist Dr Graham Jackson

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