Erectile Dysfunction Predicts Heart Disease

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Erectile dysfunction predicts coronary heart disease in type 2 diabetes, by Ronald Ching-Wan Ma and colleagues. Journal of the American College of Cardiology51:2045—2050, 2008

What is the problem and what is known about it so far?

Men with diabetes are more likely than other men to have erectile dysfunction (ED). Recent studies have suggested that ED may be closely linked to atherosclerosis, the build-up of waxy material in blood vessels that can lead to heart and blood vessel diseases.

Why did researchers do this particular study?

The researchers wanted to find out whether the presence of ED indicates the likelihood of heart disease events in people with type 2 diabetes.

Who was studied?

The study included 2,306 Chinese men with type 2 diabetes and no evidence of heart disease.

How was the study done?

The men were tested for diabetes complications. They were then followed for an average of 4 years to find out how many had heart disease events. Statistical analyses were performed to find out which factors and complications were related to the events.

What did the researchers find?

Men who had heart disease events were older and more likely to have ED and other diabetes complications than those who did not experience such events. They also had higher blood pressure, higher cholesterol, and higher levels of urine protein (a sign of kidney disease) than those who did not experience such events. After taking these and other factors into account, however, men with ED were still 1.6 times more likely to experience heart disease events than those without ED.

What were the limitations of the study?

This study was performed in Chinese men, who have lower rates of heart disease than Caucasian men, Therefore, its findings may not fully apply to other populations. Also, the study used National Institutes of Health criteria to identify ED, which involved asking a single question in interviews with patients. Because sexuality is a cultural taboo in China, this may have affected the accuracy of patients' reporting of ED. The fact that the men came from one medical center and testing was performed at one laboratory may have introduced some errors. Also, at the time the study was performed, cardiac testing was not routinely performed on patients without symptoms, so the study may have included some people with unidentified silent heart disease. Finally, the study was unable to fully assess the role that various medicines may have played in the development of ED. However, its results still show a clear link between ED and later heart disease.

What are the implications of the study?

ED appears to be an early marker of heart disease in men with type 2 diabetes. Because early attention can help prevent heart disease, health care professionals should actively ask about symptoms of ED in their efforts to assess patients' risk for future heart disease.

FOR MORE INFORMATION

Diabetes, heart disease, and stroke

Diabetes and men's sexual health

Sex and diabetes