ED May Raise Diabetic Men's Heart Risk

May 20, 2008 -- Erectile dysfunction (ED) may predict fatal or life-threatening heart disease in men with type 2 diabetes, two new studies show.

Previous research has linked erectile dysfunction to heart disease. The new studies take that research one step further by looking at the risk in men with type 2 diabetes, who are already at higher risk of heart disease and ED because of their diabetes.

The new studies, conducted in Hong Kong and Italy, together included nearly 2,600 men with type 2 diabetes.

The bottom line: Among men with type 2 diabetes, those with ED were more likely to have a major cardiovascular "event" -- including sudden cardiac death, heart attack, and stroke -- than men without ED.

That might also be true, to a lesser extent, in men without diabetes, according to an editorial published with the studies in the Journal of the American College of Cardiology.

Doctors treating men with diabetes "should ask about ED and aggressively treat cardiovascular risk factors that these patients might have, including dyslipidemia [problems with blood lipids such as cholesterol] and hypertension [high blood pressure]," states the editorial.

ED, Diabetes, Heart Disease Studies

The new Italian study included 291 men with type 2 diabetes; 45% had ED.

All of the men also had been treated for coronary artery disease; most had had coronary bypass operations. When the study started, they hadn't had any obvious symptoms from their heart disease.

The men were followed for nearly four years, on average. During that time, the group had 49 major cardiovascular "events," including death, nonfatal heart attack, stroke, and unstable angina ( chest pain).

Those events were twice as likely among men who reported ED at the start of the study, even after the researchers considered the men's other heart hazards.

Taking statin drugs, which lower LDL ("bad") cholesterol, lowered that risk. ED drugs such as Viagra might also lower the risk, but the study didn't prove that, note the researchers, who included Carmine Gazzaruso, MD, PHD, of the Clinical Institute Beato Matteo in Pavia, Italy.

In the Hong Kong study, researchers followed 2,306 men with type 2 diabetes who had no obvious signs of heart disease. At the study's start, almost 27% of the men reported having ED.

The men were followed for four years. During that time, 123 men had a cardiovascular "event," which included death, nonfatal heart attack, or other nonfatal heart disease.

Men with ED were 58% more likely to have a cardiovascular "event," regardless of their age and other risk factors, report the researchers, who included Peter C.Y. Tong, PhD, of the Chinese University of Hong Kong and the Prince of Wales Hospital.

"Both of these important studies suggest that in diabetic patients, ED is a predictor of future cardiovascular events," writes editorialist Robert Kloner, MD, PhD, FACC, of the Heart Institute at Good Samaritan Hospital in Los Angeles.