and Medicine for Seniors
Erectile Dysfunction More Likely in Men with Early
‘Erectile function can be a window into men’s
cardiovascular and overall health’
Nov. 18, 2014 — Men who have asymptomatic
subclinical vascular disease are more likely to develop erectile
dysfunction than men who don’t have early stage vascular disease,
according to research presented at the American Heart Association’s
Scientific Sessions 2014.
“Erectile function can be a window into men’s
cardiovascular and overall health,” said David I. Feldman, B.S., lead
author and research assistant at the Ciccarone Center for the Prevention
of Heart Disease at Johns Hopkins in Baltimore, Maryland. “Erectile
dysfunction and cardiovascular disease commonly coexist.”
Researchers studied 1,862 men without existing
and assessed the relationship between early atherosclerotic
development and arterial stiffness and dysfunction with their subsequent
self-reporting of erectile dysfunction.
“We looked at which measurement of early vascular
disease was the best predictor for erectile dysfunction,” Feldman said.
“We also looked at whether those men with multiple abnormalities, such
as increased plaque in addition to arterial stiffness and dysfunction,
were more likely to also suffer from erectile dysfunction.”
● Men with coronary artery calcium scores
greater than 100 Agatston units were 43 percent more likely to later
self-report erectile dysfunction compared to otherwise identical men
with normal calcium scores. (The Agatston Score is a measure of the
amount of calcified plaque in the coronary arteries.)
● Men who subsequently had erectile dysfunction
were at least two times more likely to have coronary artery calcium
scores greater than 100 Agatston units at the start of the more than
● While coronary artery calcium had the
strongest association to erectile dysfunction, other measures of early
vascular disease, including carotid intima-media thickness (cIMT), were
notably worse among men with erectile dysfunction compared to those
without. cIMT measures plaque build-up in your carotid arteries that
supply blood to the head, neck, and brain.
● After considering age, race, sex and
traditional risk factors — such as diabetes, smoking, high cholesterol
and obesity — men with abnormalities of both atherosclerosis as well
arterial stiffness and dysfunction were 53 percent more likely to later
self-report erectile dysfunction.
To improve long-term erectile function and reduce
the risk for worsening cardiovascular health, at-risk men should eat a
heart-healthy diet, engage in physical activity and avoid smoking,
“Current guidelines recommend exercise stress
testing and an ankle-brachial index test for risk assessment in patients
with erectile dysfunction,” he said. “Our results suggest a more
powerful indicator is direct measurement of coronary plaque through the
use of a coronary artery calcium test.”
More research is needed before physicians routinely
use coronary artery calcium tests over other noninvasive methods to
assess men’s sexual health, Feldman said. And more work needs to be done
on how best to prevent erectile dysfunction in those men with confirmed
asymptomatic vascular disease.
Researchers excluded men on impotence drugs and
couldn’t ensure that all men were free of erectile dysfunction at the
study’s baseline examination.
Co-authors are Kevin L. Billups, M.D.; Andrew P.
DeFilippis, M.D.; Kanchan Chitaley, Ph.D.; Philip Greenland, M.D.; James
H. Stein, M.D.; Matthew J. Budoff, M.D.; Zeina Dardari, M.S.; Roger S.
Blumenthal, M.D.; Khurram Nasir, M.D., M.P.H.; and Michael J. Blaha,
M.D., M.P.H. Author disclosures are on the abstract.