ED & Heart Disease: It's All in the Plumbing

Erectile dysfunction.  ED.  Impotence.  Failure to launch.  Whatever name you call this phenomena, it's nothing more than an emotional nuisance dragging down your confidence, right?  After all, just go to your family doc and ask for some samples of Cialis, Levitra, Stendra or Viagra.  Heck, you can even go online these days and get these medications without a prescription (scary, huh?).  So what's the big deal?

In a systematic review of the literature published early online last week in Circulation: Cardiovascular Quality and Outcomes, the authors concluded that erectile dysfunction, especially when defined by a questionnaire as opposed to a single question, was linked to an increased risk of heart disease & all-cause mortality (death from any cause), especially in younger men and those w/intermediate risk.  The authors based their conclusion on an analysis of 14 studies involving over 92,000 men followed for more than 6 years.  

For those of us in the medical profession, this study suggests that we shouldn't be so blase when a (younger) man comes in complaining of erectile dysfunction, but that instead, we need to consider how ED might be the canary in the mine warning us/him of impending heart disease.  Sure, phosphodiesterase-5 (PDE-5) inhibitors are still the drug of choice for this condition (unless said patient is already taking a nitrate), but we need to more aggressively search for evidence of plumbing issues elsewhere in the body.  After all, a healthy strong erection suggests adequate blood flow to the penis while a weak or non-existent erection suggests inadequate or poor blood flow.  And since blood vessels are blood vessels regardless of what organ they perfuse, lack of flow to one body part portends lack of flow to another.

So guys, sure, everyone has an occasional bad performance & flubs their lines now & then.  But if this is a recurring problem, don't just laugh this off.  Get checked out.  And in the meantime, stop smoking!

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