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13 October 2005
New Study Firms Up Impotence-Heart Disease Link
by George Atkinson

New research has added weight to the findings from an earlier study that linked erectile dysfunction to coronary artery disease. The authors of the new study say that erectile dysfunction may be a sign that coronary artery disease is developing, even in men without typical risk factors.

Researcher Emilio Chiurlia, from the University of Modena in Italy, said erectile dysfunction appeared to be a reliable early warning system for coronary disease. "We think that erectile dysfunction represents the 'tip of the iceberg' of a systemic vascular disorder; thus potentially preceding severe cardiovascular events. Erectile dysfunction should be part of a cardiovascular risk assessment. These patients should be considered at high risk for coronary artery disease and should have high priority for aggressive treatment."

The study, published in the Journal of the American College of Cardiology, looked at two groups of men with similar coronary risk factors. The difference was that one group suffered from erectile dysfunction while the other group did not. The researchers found that the men with erectile dysfunction had higher levels of C-reactive protein (an indicator of coronary risk). Additionally, they were also more likely to have abnormal blood vessel responses to changes in blood flow and more of them had coronary artery calcifications.

Chiurlia said erectile dysfunction should raise doctor's suspicions about early coronary disease, even in men who would not otherwise be considered at high risk. "When a man is diagnosed with erectile dysfunction, clinicians should be aware that erectile dysfunction could represent an early clinical manifestation of a diffuse sub-clinical vascular disease and coronary artery disease. The smaller penile arteries suffer obstruction from plaque burden earlier than the larger coronary arteries hence erectile dysfunction may be symptomatic before a coronary event."

While the study involved only a small number of men, other researchers agreed that the findings could have major implications for the diagnosis of coronary disease. "The present study… lends strong support to the notion that erectile dysfunction may be an early warning sign of clinically-silent coronary artery disease. …it is a strength of the present work that it assesses major aspects connecting erectile dysfunction and more generalized vascular disease in one study," Dr. Renke Maas, from the University-Hospital in Hamburg, noted.

Chiurlia urged that more research should be undertaken. "We need prospective studies addressing the precise role of erectile dysfunction as a marker of cardiovascular disease," he concluded.

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