International experts are calling for all men experiencing impotence to undergo thorough medical assessments, after an extensive review showed that a significant proportion of men with erectile dysfunction (ED) exhibit early signs of coronary artery disease (CAD).
A paper published in the June issue of IJCP, the International Journal of Clinical Practice, shows that men with ED will often develop coronary symptoms within two to three years of impotence and actually experience a cardiovascular event, such as a heart attack, within three to five years.
The authors stress that it is vital that clinicians stabilise cardiovascular function and control any symptoms before even considering initiating any ED therapy.
Dr Graham Jackson, a London-based cardiologist and Chair of the Sexual Advice Association, teamed up with 11 experts from all over the UK, Italy, Greece and the USA to analyse the findings of more than a hundred studies on the links between ED and CAD.
They concluded that:
A number of studies have sought to quantify the increased risk.
The authors suggest that the link between the two conditions could be due to atherosclerosis, a systemic condition where plaque builds up inside the arteries, leading to restricted blood flow.
"It has been suggested that because the arteries supplying the penis are smaller than those supplying the heart, they will be affected by reduced blood flow - a major cause of ED - before the symptoms of CAD develop" explains Dr Jackson.
"This theory may underpin the findings that men with ED seldom report overt symptoms of CAD, but those with CAD often report pre-existing ED symptoms."
The paper goes on to discuss prevention strategies and how patients should be assessed, tested, managed and followed up. Special guidance is also provided on dealing with patients with diabetes.
"The evidence supporting the relationship between ED and cardiovascular disease has continued to increase over recent years and yet recognition of the association remains limited among healthcare professionals and the general public" concludes Dr Jackson.
"Clinicians who specialise in managing ED support the evidence that ED is a critical predictor of cardiovascular disease and that men with ED therefore face an increased risk."
The authors, who have extensive experience of cardiovascular and sexual medicine, hope that the evidence and consensus detailed in their IJCP paper will encourage greater international interest and research on the association between ED and CAD.
"Recognising the relationship between ED and CAD will improve and save lives" says Dr Jackson. "That is why wider awareness of the links is essential."
Notes to editors
Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus. Jackson et al. IJCP. 64.7, 848-857. (June 2010). DOI: 10.1111/j.1742-1241.2010.02410.x
IJCP, the International Journal of Clinical Practice was established in 1946 and is edited by Dr Graham Jackson. It provides its global audience of clinicians with high-calibre clinical papers, including original data from clinical investigations, evidence-based analysis and discussions on the latest clinical topics. The journal is published by Blackwell Publishing Ltd, part of the international Blackwell Publishing group. www.ijcp.org www.twitter.com/IJCPeditors
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