Erectile Dysfunction and Heart Disease Linked to Increased Risk of Death
Erectile dysfunction (ED) is associated with atherosclerosis and heart disease. A new study published online in the March 15th issue of the journal Circulation reports men with ED and heart disease are twice as likely as men with only heart disease to suffer death from any cause and twice as likely to have a heart attack.
The German researchers, lead by Dr. Michael Bohm, evaluated the collected data on 1549 patients with heart disease who took part in two trials: ONTARGET or TRANSCEND. In the ONTARGET study, patients were randomly assigned to receive ramipril (400), telmisartan (395), or the combination of the two drugs (381). In the TRANSCEND study, patients were randomly assigned to receive telmisartan (171) or a placebo (202).
All patients had an ED evaluation at baseline, at 2-year follow-up, and at the penultimate visit before closeout. They were classified as having mild, mild-to-moderate, moderate or severe erectile dysfunction. In both trials, in addition to cardiovascular disease, 55 percent of the men also had erectile dysfunction.
The researchers found men suffering from erectile dysfunction were more likely to have high blood pressure, stroke, diabetes and lower urinary tract surgery, compared to men without erectile dysfunction.
The researchers found the study medications did not influence the course or development of ED, but the presence of ED was found to be predictive of the risk of death.
Men with ED were found to be 1.84 times as likely to die from any cause as men without ED (hazard ratio [HR] 1.84). Separated out, the risk of death from a cardiovascular death was 1.94 times as high. The risk of a stoke was 1.1 times as high. The risk of being hospitalized for heart failure was 1.2 times as high.
Erectile dysfunction is linked to the endothelial dysfunction (problems with the cells that line the blood vessels) that occurs in atherosclerosis and the vascular disturbances such as the build-up of plaque that happens before heart attack and stroke, the study authors explained.
If a man has Erectile Dysfunction, but has not been diagnosed with heart disease, he and his doctor need to take another look. ED is a risk factor for cardiovascular disease just as high blood pressure and cholesterol are.
Michael Böhm, Magnus Baumhäkel, Koon Teo, Peter Sleight, Jeffrey Probstfield, Peggy Gao, Johannes F. Mann, Rafael Diaz, Gilles R. Dagenais, Garry L.R. Jennings, Lisheng Liu, Petr Jansky, Salim Yusuf, and for the ONTARGET/TRANSCEND Erectile Dysfunction Substudy Investigators; Erectile Dysfunction Predicts Cardiovascular Events in High-Risk Patients Receiving Telmisartan, Ramipril, or Both. The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) Trials
Circulation 2010: published online before print March 15, 2010, 10.1161/CIRCULATIONAHA.109.864199.