Impotence: early sign of heart disease

For some men, erectile dysfunction (ED) could be an early warning of heart disease. Researchers have found that men who have ED but are otherwise healthy show signs of blood flow problems in the arm's brachial artery, signalling that problems with blood flow went beyond the penile arteries. Most cases of ED arise from impaired blood flow to the penis, and it's known that ED and cardiovascular disease share many of the same risk factors, including high blood pressure, diabetes, high cholesterol and smoking. Researchers from the St. Paul Heart Clinic in Minnesota, USA, studied 30 men with ED out of which none were recent smokers or had high blood pressure, diabetes or high cholesterol. The researchers looked at several measures of blood vessel structure and function in these men, and compared them with those of 27 men of the same age without ED. It was found that in participants with ED, the brachial artery showed less dilation or widening in response to nitro-glycerine, a drug that promotes blood vessel dilation. This suggests the men had widespread dysfunction in a particular chemical pathway, called NO-cGMP for short, involved in blood vessel dilation. This pathway is known to play a key role in ED, and is also involved in atherosclerosis, a hardening and narrowing of arteries that can lead to heart attack and stroke.

Hence ED might be the first manifestation of widespread trouble in the blood vessels. Many patients with ED have a vascular mechanism similar to that seen in atherosclerosis, so it's presence should alert the doctor to the possible presence or future development of cardiovascular disease. However, more research is needed that follows otherwise healthy ED patients to see whether they do develop higher-than-average rates of cardiovascular disease.