Erection problems a red flag for ‘silent’ heart disease and early death

Men with erection problems now have an extra reason to see their doctor: even relatively minor erectile difficulties could signal ‘silent’ heart disease and may indicate an increased risk of dying early from any cause, a major new study shows.

An Australian study – the world’s largest to investigate the link between erectile dysfunction and heart disease – has found that men with erectile dysfunction have a higher risk of hospital admission for heart disease, even if they have no history of heart problems. They are also at greater risk of premature death from any cause.

The research, from the Sax Institute’s 45 and Up Study and published in international journal PLOS Medicine today, is the first to show a direct link between how severe a man’s erection problem is and his risk of dying early or being treated in hospital for heart disease.

“The risks of future heart disease and premature death increased steadily with severity of erectile dysfunction, both in men with and without a history of cardiovascular disease,” lead author and 45 and Up Study Scientific Director Professor Emily Banks said.

“Rather than causing heart disease, erectile dysfunction is more likely to be a symptom or signal of underlying ‘silent’ heart disease and could in future become a useful marker to help doctors predict the risk of a cardiovascular problem. This is a sensitive topic but men shouldn’t suffer in silence; there are many effective treatments, both for erectile dysfunction and for cardiovascular disease.”

Erection problems are very common: around one in five men aged 40 and over report moderate or severe erectile dysfunction.

While previous studies have shown that men with severe erectile dysfunction are more likely than men with no erectile difficulties to have cardiovascular events such as heart disease or stroke, this study (funded by the Heart Foundation and the NSW Office for Health and Medical Research) is the first to review gradients of erectile dysfunction from none, to mild, moderate and severe forms.

Heart Foundation Cardiovascular Health Director Dr Rob Grenfell said the results were nationally significant and demonstrated why governments should invest in large health studies such as the 45 and Up Study.

“These results tell us that every man who is suffering from any degree of erectile dysfunction should be seeking medical assistance as early as possible and also insisting on a heart health check by their GP at the same time,” Dr Grenfell said.

The researchers, from the Sax Institute, Australian National University, The University of Sydney, Victor Chang Cardiac Research Institute and The George Institute for Global Health examined hospital and death records for 95,000 men from the 45 and Up Study – the largest ongoing study of healthy ageing in the Southern Hemisphere, with more than 250,000 people taking part. The men gave information about health and lifestyle factors and were followed for a two to three-year period, recording 7855 hospital admissions related to cardiovascular disease and 2304 deaths.

“The large number of men in the study meant we could also look at the risks in relation to different types of cardiovascular disease,” Professor Banks said. “We found men with erectile dysfunction were at higher risk of heart attack, heart failure, peripheral vascular disease and heart conduction problems.”

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