Younger Men with ED Have a Higher Risk of Coronary Disease

Erectile dysfunction (ED) is often due to degenerative changes in the arteries supplying the penis. In fact, an Italian study has shown that ED can precede coronary artery disease by 2-3 years. The Mayo Clinic Proceedings has now published the report of a study of this problem in US men.

Duke University scientists screened a random sample of 1402 community-dwelling men for the presence of ED,twice a year for 10 years. The men had no known coronary disease, and were representative of the overall male population (albeit predominantly white). “Incident cardiac events” (sudden cardiac death, heart attack, severe coronary angina, and coronary disease diagnosed by angiography) were recorded. Erectile function was assessed by a self-report questionnaire consisting of 11 items rated on a scale of 0 to 4, with higher scores representing better sexual function.

The frequency of ED, after adjustment for diabetes, high blood pressure, smoking, and body mass index (BMI), was calculate for 10-year groups of men, based on age. Baseline frequency was 2% for men aged 40 – 49, 6% for men aged 50 - 59, 17% for men aged 60 - 69, and 39% for men 70 and older. Overall, coronary artery disease developed in 11% of men during the 10-year period (6% sudden death, 15% heart attacks, and 79% having abnormal angiograms).

Most importantly, the cumulative frequency of coronary disease was strongly influenced by the men’s age: the frequencies per 1000 man-years for those without ED were 0.9 at age 40-49, 5 at age 50-59, 11 at age 60-69, and 23 at age 70 or more. For men with ED, these frequencies were 49, 27, 24, and 30, respectively.

It’s clear that, when ED occured in younger men (i.e. below 60 years), it was associated with a marked increase in the risk of future coronary disease, whereas in older men it was less predicitve. In fact, in men under 50, ED was associated with a nearly 50-fold increase in the 10-year frequency of coronary artery disease.

Obviously, all men with ED should be assessed for their cardiovascular risk, with special attention to younger men with the problem. Reversal of atherosclerosis is by no means impossible, given modern treatment methods.