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COLUMN BY SUSAN HILL

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EDucation

posted 06/02/2008
If you (or your partner) take medication like Viagra or Cialis, perhaps you should be more worried about your heart than your sex life. Anyway, if your ticker quits, the rest of you not working will be a moot point. In fact, it seems that erectile dysfunction (ED) may represent "the canary in the coal mine" as a predictor of more serious, but as yet asymptomatic heart disease.

Two recent independent studies among diabetic men in Italy and Hong Kong have identified erectile dysfunction as an indicator of increased risk for developing coronary artery disease and heart attack. These results confirm the findings of other research on non-diabetic men reported in the last couple of years. So a cholesterol lowering statin drug (like Lipitor, Crestor and others) may also be prescribed for your erectile difficulties. Why is that so?

The small blood vessels in the body tend to plug with cholesterol sooner than larger vessels. Smaller vessels supply most of the body's organs including the brain, heart, kidneys and extremities. In the penis, small blood vessels allow the blood to flow to the penis causing engorgement and thus erection. Even when the spirit is willing, if the vessels are plugged, the response is weak.

Smoking also increases the risk for atherosclerosis (cholesterol plaques) in the vessels by inflaming the blood vessels and attracting cholesterol to "stick." Diabetes adversely impacts lipid metabolism and creates more of the bad cholesterol LDL which clogs the vessels. However, not all erectile difficulties are caused by cholesterol deposits.

It's Not Just a Coincidence

The incidence of erectile dysfunction (ED) and coronary artery disease (CAD) in men is strikingly similar.

By age 40, 40% of men have some degree of erectile difficulties and 39% of men have heart disease. By 70 years of age, 71% of males have heart disease and 70 % of men have erectile dysfunction.

Hypertension, certain medications used to treat high blood pressure and other drugs can contribute to erection difficulties. Prostate surgery and neurologic diseases like Parkinson's and multiple sclerosis can also adversely affect erectile function. Obesity is associated with impotency as are psychological factors. The normal aging process also causes diminished erectile function as testosterone levels naturally decline with age. Yet, for most men in the U.S., where the diet is high in fat and the activity level is low, cholesterol blockage of the arteries is the most common cause of erectile dysfunction.

There is hope though. Just as statins can reverse cholesterol deposits in the critical vessels that supply the heart, the blood flow to the penis can be improved. Studies have shown that after taking statin-type medication for two years, there is measurable improvement in the blood flow through the vessels.

So, if you are asking your health care provider about Viagra or Cialis, think about your heart and get your cholesterol levels tested too. In addition to medication and a low fat diet, regular aerobic exercise helps flush the blood vessels, improves stamina and physical conditioning—and benefits all of your body.

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Susan C. Hill © 2008

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