Erectile Dysfunction Linked to Atherosclerosis
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Erectile dysfunction should be added to a growing list of risk factors for Heart disease, according to a team of Italian researchers.
They based their recommendation on a small study of men with vascular Erectile dysfunction, and they called it an additional “early warning sign of Atherosclerosis."
Compared with men with no evidence of vascular penile disease, men undergoing treatment for erectile problems have significantly higher levels of C-reactive protein (CRP), (P<0.001), impaired endothelial function (P<0.001), and more coronary artery calcification (P=0.01), said Emilio Chiurlia, Ph.D., of the University of Modena.
"We think that Erectile dysfunction is the ‘tip of the iceberg’ of a systemic vascular disorder,” said Dr. Chiurlia and colleagues. They reported their findings in the Journal of the American College of Cardiology.
An erection problem is the inability to get or maintain an erection that is firm enough for a man to have intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction.
Considerations
Erection problems are common in adult men. In fact, almost all men experience occasional difficulty getting or maintaining an erection. In many cases, it is a temporary condition that will go away with little or no treatment. In other cases, it can be an ongoing problem that can damage a man’s self esteem and harm his relationship with his partner, and thus requires treatment.
The investigators added that patients with vascular Erectile dysfunction should “be considered at high risk for coronary artery disease and should have high priority for aggressive treatment.”
If the findings are confirmed by additional studies, Erectile dysfunction should be used together with other cardiovascular risk factors to discriminate patients needing further investigation for subclinical coronary artery disease, they added.
Dr. Chiurlia and colleagues studied 70 consecutive Erectile dysfunction patients and 73 age- and risk factor-matched controls.
Atherosclerosis is a condition in which fatty material is deposited along the walls of arteries. This fatty material thickens, hardens, and may eventually block the arteries.
Atherosclerosis is just one of several types of “arterio"-sclerosis, which is characterized by thickening and hardening of artery walls, but the two terms are often used to mean the same thing.
Causes, incidence, and risk factors
Atherosclerosis is a common disorder of the arteries. Fat, cholesterol, and other substances accumulate in the walls of arteries and form “atheromas” or plaques.
Eventually, this fatty tissue can erode the wall of the artery, diminish its elasticity (stretchiness) and interfere with blood flow. Plaques can also rupture, causing debris to migrate downstream within an artery. This is a common cause of heart attack and stroke.
Participants and controls were evaluated for circulating CRP, which is an emerging cardiovascular disease risk factor. They also underwent multislice computed tomography and ultrasound of the brachial artery to assess endothelial function.
Circulating median high-sensitivity CRP was significantly higher in subjects, 2.62 mg/l versus 1.03 mg/l in controls (P<0.001), while flow-mediated dilation was significantly lower (2.36±1.75 versus 3.92±2.2 P<0.001). However, nitroglycerin-mediated dilation was not significantly different between the two groups.
Overall, both coronary artery calcification and calcium score assessed by CT were higher among men with Erectile dysfunction. The odds ratio for coronary artery calcification was 2.75, 95% CI 1.26 to 5.26 (P=0.01) while the mean calcium score was 143.3 in patients versus 32.4 in controls.
The authors noted that the findings are limited by the small sample size and the lack of long-term follow-up.
“In our opinion, Erectile dysfunction should be considered, like diabetes, a cardiovascular equivalent,” Dr. Chiurlia wrote.
Primary source: Journal of the American College of Cardiology
Revision date: July 3, 2011
Last revised: by Amalia K. Gagarina, M.S., R.D.
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