Q. Is erectile dysfunction a possible symptom of heart problems?

Erectile dysfunction (ED), which is inadequate erection for sex, can indicate that something is wrong with your heart. Here’s why:

Blood flowing to the penis creates erections. Plaque buildup narrows and hardens arteries (atherosclerosis), reducing blood flow throughout the body.

The arteries supplying blood to the penis are smaller than those for the heart. So, ED can be an early sign of atherosclerosis, which can increase your risk of heart attack and stroke.

The risk factors for heart disease signaled by ED are:

Age. Younger men are more likely to have heart disease with ED. Men under 50 are at especially high risk. ED in men over 70 is probably not a sign of heart problems.

Medications such as diuretics, antihypertensives, antihistamines, antidepressants, Parkinson’s disease drugs, antiarrhythmics, tranquilizers and muscle relaxants.

Genes. It’s more likely ED could be a sign of heart disease if you who had a close relative with heart disease at an early age.

Also: High blood pressure, elevated LDL (“bad” cholesterol), obesity, diabetes, smoking, inactivity and depression.

Ian M. Thompson, MD, a urologist at the University of Texas Health Science Center at San Antonio, did a study that showed a strong association between ED and heart disease.

“Our data suggest that older men in this group [with ED] have about a twofold greater risk of cardiovascular disease than men without erectile dysfunction,” Thompson said.

Dr. Thompson’s study involved 9,457 men over a seven-year period. All were aged 55 or older.

The study found that men who reported erectile dysfunction for the first time during the study carried a 25 percent increased risk for developing subsequent heart disease during follow-up. In men who had ED from the beginning of the study, the risk of developing subsequent heart disease risk was 45 percent.

German researchers also reported that men with ED are twice as likely to suffer from cardiovascular disease.

Dr. Michael Bohm, a cardiologist at Germany’s Saarland University, and his colleagues studied 1,519 men from 13 countries who were involved in a study of drugs to treat cardiovascular disease. The men were asked about their ED at the beginning of the study, two years into it and at the end at five years. There were 55 percent with ED at the beginning of the trial, nearly double the normal incidence of about 30 percent in the population at large.

The team reported that, in the five years of follow-up, men with ED were 1.9 times as likely to die from heart disease, twice as likely to have a heart attack, 1.2 times as likely to be hospitalized for heart failure and 1.1 times more likely to have a stroke.

The studies in the United States and Germany are just of two of more than 100 studies linking heart disease to ED. Cardiologists urge men with ED to get a complete medical exam to screen for coronary artery disease that can lead to heart attack.

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