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ED, Heart Disease May Be Deadly Duo

Men With ED and Cardiovascular Disease Have Higher Risk of Early Death, Study Finds
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WebMD Health News
Reviewed by Laura J. Martin, MD

March 15, 2010 -- Erectile dysfunction is a major warning sign for cardiovascular disease and early death.

The finding comes from placebo-controlled studies comparing randomly selected men with ED and cardiovascular disease and men without ED.

The men with ED and cardiovascular disease were:

  • 1.9 times more likely to die from cardiovascular disease
  • Twice as likely to have a heart attack
  • 1.2 times more likely to be hospitalized for heart failure
  • 1.1 times more likely to have a stroke

The researchers say they found that medications like ramipril, an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure and heart failure, can reduce cardiovascular events but don’t seem to influence the course or development of ED.

“Erectile dysfunction is something that regularly should be addressed in the medical history of patients,” Michael Bohm, MD, lead author of the study and chairman of internal medicine at the University of Saarland in Germany, says in a news release. “It might be a symptom of early atherosclerosis.”

The study included 1,549 male cardiovascular patients in 13 countries. Each was asked if he had ED, and men who answered in the affirmative were then categorized as having mild, mild-to-moderate, moderate, or severe ED. The average follow-up was five years.

Patients in one trial involving 400 men were randomly assigned to take ramipril, telmisartan -- an angiotensin II receptor antagonist used to treat hypertension and heart failure  -- or a combination.

In another, ACE inhibitor-intolerant patients were randomly assigned to take a placebo or telmisartan.

Patients with ED were older and had a higher prevalence of hypertension, stroke, diabetes, and lower urinary track surgery than men without ED. And 55% of men had ED when they entered the trials.

Researchers say deaths from all causes occurred in 11.3% of patients who had ED at the start, but in only 5.6% of people with no ED or only mild problems at baseline.

They report that 16.2% of ED patients died from cardiovascular problems, suffered heart attacks or strokes, or were hospitalized for heart failure. Only 10.3% of men with no or mild ED had similar outcomes.

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