Are erectile problems an early sign of heart disease?

Erectile problems precede a heart attack or stroke by an average of 2 to 5 years. This is no coincidence: the inner lining of blood vessels functions poorly in both conditions, and that is the shared disease mechanism. The same risk factors, diabetes, high blood pressure, smoking, excess weight, elevated cholesterol and physical inactivity, damage the blood vessels in the penis as well as those in the heart.

The explanation for this sequence is anatomical. The arteries in the penis are narrower than the coronary arteries. The same degree of arterial hardening therefore causes noticeable symptoms in the penis before it does in the heart. As a result, erectile problems appear, as it were, as the first symptom of a broader vascular problem. Arterial hardening that causes no symptoms at all may precede vasculogenic erectile problems by a decade or more, with the erectile problems themselves then still appearing before a heart attack or stroke.

Not all erectile problems are a vascular signal. Problems caused by psychological factors or hormonal disorders do not belong in this category. The focus is specifically on so-called vasculogenic erectile problems, in which blood flow is the underlying cause. Men between the ages of 40 and 60 with this type of complaint have the highest risk of a future cardiovascular event. Up to two thirds of men in whom coronary artery disease has been diagnosed turn out to have erectile problems as well.

Cardiologists and urologists agree that a man with erectile problems and no known heart disease should receive a cardiovascular assessment. The message is: do not settle for a potency pill alone, but also have your blood pressure, cholesterol and blood sugar checked. In men with a low cardiovascular risk, treatment of the erectile problems can be safe and effective. If you have active cardiac symptoms or a high risk, consulting a cardiologist is wise before taking any action.