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Impotence can be a warning sign for heart disease

University Of Chicago : 28 June, 2007  (Technical Article)
A University of Chicago study has found impotence also can be a warning sign for heart disease. Researchers found the link between impotence and heart disease is stronger than that of any other known risk factor, including smoking, family history and high blood pressure.
A second study reported Monday found that nearly one in five American men over age 20 are impotent. The rate ranges from 3.8 percent of men in their 30s to 77.5 percent of men 75 or older.

Impotence 'is highly prevalent, and men should not feel embarrassed if they suffer from it,' said UCLA urologist Dr. Christopher Saigal, lead researcher of the second study.

'A vascular disease'

The studies are published in the Archives of Internal Medicine.

Impotence, technically known as erectile dysfunction, does not cause heart disease. Rather, both conditions usually are due to the same underlying disease of blood vessels, said University of Chicago cardiologist Dr. R. Parker Ward.

Impotence typically results when blood vessels do not open sufficiently to allow enough blood to flow to the penis to cause an erection.

'Erectile dysfunction needs to be recognized as a vascular disease,' Ward said.

Ward co-authored a study of 221 men who were given stress tests because of known or suspected heart disease. Researchers found that 54.8 percent of these heart patients also had erectile dysfunction. Moreover, those who had erectile dysfunction tended to have more severe heart disease.

Other causes

Because arteries in the penis are smaller than arteries in the heart, 'they may be more prone to cause erectile dysfunction with even comparatively small amounts of [vascular disease],' researchers wrote.

When screening men for heart disease, doctors typically check risk factors such as diabetes, smoking and cholesterol. Ward said it might also make sense to ask about erectile dysfunction, even though the topic makes some men uncomfortable.

'We may need to ask male patients a new set of sensitive questions.'

Ward added, however, that impotence is not always a vascular condition. It sometimes is caused by psychological or emotional problems, or by nerve damage from diabetes or prostate surgery.

Racial differences

In the second study, researchers analyzed a national survey of 2,126 men who were asked: 'How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?' Men who answered 'Never able' or 'Sometimes able' were considered to have erectile dysfunction. Among all men, the rate was 18.4 percent.

Rates were similar among whites and blacks. But the Hispanic rate was 1.9 times higher than the white rate.

Researchers speculated the higher Hispanic rate might be due to disparities in health care or to cultural differences in how men answered the survey. It's possible some Hispanics indicated they had erectile dysfunction when they actually had other problems, such as premature ejaculation or failure to achieve orgasm, Saigal said.
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