Erectile dysfunction (ED) is estimated to affect more than half of men between ages 40 and 70 and about 70 percent of men over the age of 70.
Although an association between ED and coronary heart disease (CHD) was suggested more than 20 years ago, an outpouring of research studies over the past six years has established a firm link between the two disorders.
ED and coronary heart disease share the same risk factors:
- cigarette smoking
- elevated LDL cholesterol
- low HDL cholesterol
And the likelihood of ED increases as the number of these risk factors goes up. Both CHD and ED also share abnormalities of the endothelial cells that line the inside of all blood vessels, as well as an increased tendency for inflammation within the arterial wall.
It also appears that manifestations of coronary heart disease are likely to follow soon after the onset of ED. For example, a study reported in the Journal of the American Medical Association (JAMA) in 2005 showed a 30 percent increased risk of a cardiovascular event within five years after the onset of ED.
The above risk factors lead to CHD by speeding the development of atherosclerosis, which affects arteries throughout the body, including those supplying blood to the penis.
It is not surprising that atherosclerosis would cause ED before symptoms of CHD occur: The arteries supplying blood to the penis are even smaller than the ones bringing blood to the heart, and so can be narrowed by plaques more rapidly.
ED thus serves as a potential warning of later CHD. An important, as yet unanswered, question is whether controlling the risk factors for CHD can prevent or delay the onset of ED.
In any case, it makes sense to me for men to try to preserve their sexual function, as well as to maintain the functioning of their heart and brain, by paying close attention to their CHD risk factors.