July 18, 2006

Impotence could be sign of heart disease: study

By Patricia Reaney

LONDON (Reuters) - Men suffering from impotence should be
screened for cardiovascular disease because it could be an
early sign of the illness, Italian researchers said on

They believe erectile dysfunction (ED) could be a "sentinel
of the heart," enabling doctors to detect heart disease before
symptoms occur.

"A strict medical surveillance program should be mandatory
in patients with ED, multiple risk factors and no clinical
artery disease," said Dr Piero Montorsi of the Institute of
Cardiology at the University of Milan.

In a study of almost 300 men who suffered from impotence
and clogged arteries, 93 percent reported symptoms of ED
between one to three years before experiencing angina -- chest
pains and discomfort.

"Many patients with ED and multiple risk factors (for
cardiovascular disease) are at a higher risk of developing,
sooner or later, a coronary acute event," Montorsi told

He and his team suggested that clogged arteries also have
an impact on penile circulation. ED may develop earlier than
heart disease because the penile artery has a smaller diameter
than coronary arteries.

"This is probably the main reason why ED comes before
coronary artery disease," said Montorsi whose findings are
reported online by the European Heart Journal.

The researchers also discovered that the number of cases of
erectile dysfunction was lower in men who had a heart attack
involving one clogged blood vessel and higher in patients with
many clogged arteries or chronic coronary syndrome (CCS).

"Age, multi-vessel coronary involvement, and CCS were
independent predictors of ED," Montorsi said.

Coronary heart disease, a major killer in industrialized
countries, occurs when there is a build up of plaque which
clogs up the arteries and restricts blood flow.

High blood pressure, raised cholesterol levels, smoking,
lack of exercise and diabetes are risk factors.

Cases of erectile dysfunction increase with age. About 5
percent of 40-year-old men and up to 25 percent of 65 year-olds
experience ED. It can be caused by an illness or injury that
affects the nerves or blood flow or the side effects of drugs.

"All men with ED and no cardiac symptoms need a detailed
cardiac assessment, blood pressure measurement, fasting lipid
profile and glucose, as well as lifestyle advice regarding
weight and exercise," said Dr Graham Jackson, a cardiologist at
Guy's and St Thomas' NHS Foundation Trust in London, in a