Erectile Dysfunction Tied to Increased Risk of Heart Attacks, Stroke

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Men don’t usually want to talk about erectile dysfunction (ED). But experts say they now need to, after research from the American Heart Association (AHA) has shown evidence that men with ED have double the risk of suffering cardiac arrest, heart attack, stroke or sudden cardiac death.

The findings, reported in the AHA’s July 2018 issue of the journal, Circulation, detailed a four-year-long analysis of almost 2,000 men between ages 60 and 78. In the report, titled Erectile Dysfunction as an Independent Predictor of Future Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis, researchers found that men experiencing ED had a much higher risk of cardiovascular (CV) disease, regardless of any other risk factors (e.g. cholesterol, high blood pressure, smoking, etc.).

Younger men must seek medical attention

While all men experiencing ED may be at risk, experts say that men in their 40s and early 50s must be the most vigilant. That’s because they are far less apt to seek out medical help or screenings, which could catch underlying signs of more significant disease.

“Younger men with symptoms of ED have a three- to four-time greater chance of experiencing cardiovascular disease just five to 10 years later,” explains Dr. Ranjith Ramasamy, an expert in reproductive urology at the University of Miami Health System. “If we can get them started on effective treatments to prevent a cardiovascular incident, the potential of fatal CV outcomes can be greatly reduced.”

Preventive Screenings and Treatments

According to Dr. Carlos Alfonso, an interventional cardiologist at UHealth, the treatments prescribed for atherosclerosis – the hardening and narrowing of arteries – vary, based on the root cause of the issue for each person.

“We first take an accurate and complete medical history, to learn about any family history of heart disease. If a first-degree male relative like a brother or father had early heart disease before age 55—we then can look further into the reasons. The same goes for if one has or had a sister or mother who experienced heart disease prior to turning 65-years-old.”

Patients are then assessed for any past or current personal history of smoking, high blood pressure, high cholesterol, elevated blood glucose/sugar levels (diabetes mellitus), high triglyceride (fat cell) levels in the blood, low HDL levels (the “good” cholesterol) and peripheral vascular disease (PVD)—a blood circulation disorder.

“Many of these conditions travel in company, which can accelerate the likelihood and onset of an emergency cardiac episode,” says Dr. Alfonso. “This is known as metabolic syndrome, and it is present in almost a quarter of the adult American population.”

Why ED drugs mask the problem

Drs. Ramasamy and Alfonso both sound the alarm about simply being prescribed ED-therapy drugs such as Cialis and Viagra without a thorough cardiovascular assessment. Such medications may successfully solve the immediate need, but they do not treat the cardiovascular issues elsewhere in the body.

“If ED is a symptom of plaque build-up leading to atherosclerosis, those blockages can continue getting worse,” warns Dr. Ramasamy. “Arteries may become partially or almost completely blocked—starving the body’s organs and/or limbs of oxygen.”

An additional risk for patients being treated for an already established heart disease, says Dr. Alfonso, is the potential for ED medications to cause severe adverse reactions with other medications. Nitroglycerin and nitrates, prescribed as tablets, pills, patches, and sprays, widen arteries and decrease stress on the heart, he shares. ED pills also act to enlarge blood vessels. Both decrease blood pressure.

“If the two are taken together, not enough blood may get to the heart,” he warns. “It could lead to a profound hypotensive reaction. The dramatic drop in blood pressure might cause the person to pass out, a heart attack or a death to occur.”

Men must speak up and communicate with all their doctors, both experts advise. Erectile dysfunction can be addressed without adding major risks for cardiovascular disease, stroke and heart attacks. Embarrassment, if any, is minor when compared to ensuring a man’s long-term cardiovascular and sexual health.

“We urge men to see erectile dysfunction as a warning flag,” says Dr. Alfonso. “With prompt attention, further testing can be the preventive step needed for diagnosing early cardiovascular disease, and saving lives.”

For more information, or to schedule a confidential consultation or screening for symptoms of erectile dysfunction and/or cardiovascular disease, visit UHealth today or call 305-243-5554.


John Senall is a contributing writer for UMiami Health News. He is a former hospital and comprehensive cancer center communications director.