Unhealthy heart can cause erectile dysfunction

Men with multiple risk factors for heart disease may be more likely to develop erectile dysfunction later in life than men with optimal heart health, a recent study suggests.

Researchers focused on seven risk factors for heart disease: high blood pressure, elevated cholesterol, high blood sugar, being overweight or obese, insufficient physical activity, poor diet, and smoking. They followed 1,136 men for a decade starting in their early 60s to see how having more of these risk factors, or poor cardiovascular health, influenced the odds of developing erectile dysfunction.

“We knew that erectile dysfunction was considered an early indicator of vascular disease that might occur before heart disease was diagnosed by a doctor,” said lead study author Abbi Lane-Cordova, a preventive medicine researcher at Northwestern University in Chicago.“This study showed that men who were less likely to have risk factors for heart disease and had healthier behaviors (non-smoking, physically active, healthier diet) were also less likely to have erectile dysfunction later in life,” Lane-Cordova said by email. “Men may avoid erectile dysfunction the same way they may avoid heart disease.”

Ischemic heart disease, or hardening of the arteries, is often associated with erectile dysfunction in men over 60. The condition can reduce circulation in the penis.At the start of the study, researchers scored men on each of the seven different risk factors for heart disease, awarding 0 points for the worst outcome, 1 point for intermediate or moderate risk, and 2 points for the healthiest outcome.

In other words, men with the lowest cumulative risk across all seven measures would be awarded a total of 14 points.Then, researchers sorted participants into three groups from lowest to highest risk for cardiovascular disease.By the end of the study, 526 men, or 46 percent, had erectile dysfunction.But all of the men with the highest cardiovascular disease risk had erectile dysfunction, compared with just 15 percent of men with the lowest risk for cardiovascular disease.

The men who had erectile dysfunction by the end of the study were also more likely to have poor blood flow through their arteries at the start of the study.The study wasn’t a controlled experiment designed to prove that risk factors for heart disease directly cause erectile dysfunction.Another limitation of the study is that researchers only measured erectile function once, making it impossible to assess how changes in cardiovascular risk factors over time might influence sexual function, the authors note in the American Journal of Hypertension.

Even so, the findings add to a large body of evidence linking risk factors for cardiovascular disease to higher odds of erectile dysfunction, said Andrew Steptoe, head of the department of behavioral science and health at University College London in the U.K.

One theory about how cardiovascular disease influences erectile dysfunction has been that they lead to poor working of the blood vessels, in particular dysfunction in the cells that line the vessels, Steptoe, who wasn’t involved in the study, said by email. This in turn leads to a disruption of blood flow into the penis, resulting in erectile dysfunction. But the current study directly measured the function in this layer of cells lining the blood vessels, and it didn’t find this accounted for the impact of cardiovascular risk factors on erectile dysfunction, so it’s possible other processes may be involved, Steptoe said.

“The good news is that maintaining good cardiovascular health (not smoking, being physically active, healthy body weight and diet, blood pressure in the healthy range) has a favorable effect on erectile function just as it does on risk of heart disease,” Steptoe said. “So men who take care of their health are likely to maintain better sexual function as well as avoiding heart disease.”