ED in younger men may foretell heart disease

Men who develop erectile dysfunction (ED) in their 40s may have a heightened risk of heart disease down the road, a new study suggests.

On the other hand, researchers found, ED that arises later in life may not be as strong a predictor of heart trouble.

The study, of 1,400 men initially free of heart disease, found that those with ED were 80 percent more likely to develop coronary heart disease over the next decade - even with other risk factors, such as diabetes, obesity and high blood pressure, taken into account.

But the effects of ED appeared strongest among men who developed the condition in their 40s. They had twice the risk of heart disease as men their age without ED, the researchers report in the journal Mayo Clinic Proceedings.

In contrast, ED alone seemed to have little power to predict heart disease in men in their 50s and 60s, and there was no link between ED and higher heart risks in men in their 70s.

"The highest risk for coronary heart disease was in younger men,"

researcher Dr. Jennifer St. Sauver, of the Mayo Clinic in Rochester, Minnesota, commented in a statement.

That means that younger men with ED may need to be assessed for other heart disease risk factors - like high blood pressure, excess pounds and high cholesterol - and take measures to control them, St. Sauver and her colleagues say.

"In older men," she noted, "erectile dysfunction may be of less prognostic importance for development of future heart disease."

A number of studies have pointed to a link between ED and heart disease. ED is more common in men with certain traditional risk factors for heart disease - including obesity, diabetes and high blood pressure - but researchers believe that erectile dysfunction itself can be a harbinger of heart problems.

ED occurs when there is impaired blood flow to the penis. Widespread problems in the arteries may first become apparent in the smaller vessels supplying the penis - before blockages in the larger coronary arteries manifest.

The current findings, St. Sauver and her colleagues say, suggest that in younger men, ED "may indeed be an early manifestation of a progressive systemic (vascular disease), preceding the development of coronary disease by decades."

"Therefore," the researchers write, "young men with ED may be ideal candidates for cardiovascular risk factor screening and medical intervention."

SOURCE: Mayo Clinic Proceedings, February 2009.