It's deja vu all over again.
Yogi Berra
As I was reading a
prospective population-based study published online 2 days ago in PLOS Medicine, I thought I was experiencing Yogi Berra's above noted quote, as the
authors concluded that severity of erectile dysfunction (ED) was associated w/risk of cardiovascular disease & all-cause mortality. In fact, the authors followed for an average of 3yrs 95,038 Australians older than 45yo and took into the account the usual suspects such as age, tobacco use, alcohol consumption, education, income, physical activity, diabetes, high blood pressure, high cholesterol, and obesity (body mass index). And despite this, those
men who reported severe ED had a greater risk of heart disease and of death from any cause compared to those who denied having any ED.
And just how was ED assessed? By a single question! How often are you able to get and keep an erection that is firm enough for satisfactory sexual activity? The participants could respond with "always", "usually", "sometimes", "never", and "I would rather not answer this question" with the first 4 answers corresponding to no ED or mild, moderate & severe ED.
Well, after just a bit of digging around, I found the
meta-analysis & review article referenced in
my post from 2 weeks ago that arrived at the
same conclusion: ED is linked to cardiovascular events & all-cause mortality. What this means for you and me is that we need to go beyond just writing a prescription for Viagra or Cialis. We need to consider ED the canary in the mine and look at the patient's risk factors for heart disease & death.
Dr. Lin raises an excellent point about the need for physicians to do more for their patients with ED than simply writing out a Viagra prescription. ED should not be dismissed as a normal part of aging as it can be an outward sign of more serious diseases, including heart disease and diabetes. There are also many physiological and psychological issues that can be affecting the patient’s quality of life. For more information about the risk factors and treatment options for men with sexual dysfunction, we invite readers to check out this recent review by Neil Baum, MD, published in Clinical Geriatrics, at www.clinicalgeriatrics.com/articles/Sexual-Dysfunction-Older-Men
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