Erectile problems may be early warning of cardiovascular disease

Men with erectile problems may have more serious and unrecognised cardiovascular health issues, according to researchers writing in the October 18^th edition of the Journal of the American College of Cardiology. Erectile dysfunction can be a symptom of more advanced cardiovascular disease, but researchers have now found that men with problems attaining an erection had subclinical symptoms indicating an increased risk of future heart disease.

Anti-HIV treatment can cause an increase in blood fats and sugars which can increase the risk of heart disease and studies have found that large numbers of men taking anti-HIV therapy have erectile problems.

Italian investigators studied 70 men with erectile dysfunction and 73 men who were able to obtain an erection. Both groups of patients were of a similar age and race and had comparable risk factors for cardiovascular disease. None of the men had any symptoms suggesting that they had hardening of the arteries.

Blood tests revealed that the men with erectile dysfunction had higher levels of C-reactive protein, a risk factor for heart disease. Blood flow through the arteries, another early warning of potential cardiovascular problems was also abnormal in the men with erectile problems. In addition, CT scans showed that over a third of men with erectile difficulties had evidence of hardening of the arteries.

The investigators suggest that erectile dysfunction should make doctors think about the possibility of cardiovascular disease, even if a man has no traditional risk factors or other symptoms.

Limitations of the study include the small sample size.

There have been a number of studies looking at sexual dysfunction in HIV-positive men taking antiretroviral therapy. These have shown that between a third and 70% of HIV-positive men have experienced erectile difficulties or anther sexual problem. Treatment with a protease inhibitor has been associated with erectile problems, as have other classes of anti-HIV drug, and factors such as anxiety and depression. There is evidence that some anti-HIV drugs can increase some of the risk factors for heart disease, and that protease inhibitor treatment is associated with changes in the arteries that include calcification and increased plaque formation.