1. Home>
2. Specialties>
3. Cardiology>
4. Summary and Comment

Erectile Dysfunction: Risk Factor for Cardiovascular Disease?

More bad news associated with impotence

Erectile dysfunction (ED), which usually is caused by vascular disease of the penile arteries, might be associated with disease in other vascular beds including the heart. Partly supported by the manufacturer of sildenafil, researchers assessed whether ED can be the first clinical evidence of systemic vascular disease.

Subjects were 30 men (mean age, 47) with ED and reduced penile systolic-flow velocity; none had evidence of cardiovascular disease or histories of smoking, hypertension, hyperlipidemia, or diabetes. Compared with 27 age-matched controls without ED, the ED patients had similar coronary calcium scores, carotid- and brachial-artery diameters, and carotid intima-media thickness. However, mean change in brachial-artery flow-mediated vasodilation during the 90 seconds after cuff release was significantly lower among ED patients (1.3%) than among controls (2.4%). ED patients also had a significantly lower vasodilation response to sublingual nitroglycerin (mean maximum response, 13% vs. 18% in controls).

Comment: These data suggest that young men with ED but no clinical evidence of cardiovascular disease or other risk factors for it have generalized impairment of both endothelium-dependent and -independent vasodilation. The authors speculate that an abnormality in the peripheral vascular NO-cyclic guanosine-3'5'-monophosphate vasodilation pathway can make ED the first clinical manifestation of cardiovascular disease, potentially independent of traditional risk factors.

— Howard C. Herrmann, MD

Published in Journal Watch Cardiology March 12, 2004

Citation(s):

Kaiser DR et al. Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004 Jan 21; 43:179-84.

• Original article (Subscription may be required)
• Medline abstract (Free)

Cheitlin MD. Erectile dysfunction: The earliest sign of generalized vascular disease? J Am Coll Cardiol 2004 Jan 21; 43:185-6.

• Original article (Subscription may be required)
• Medline abstract (Free)