MedWire News: Cardiovascular (CV) risk assessments in men should take into account erectile dysfunction, argues one expert in a letter published online in the British Medical journal.
Geoffrey Hackett, a consultant in urology at the Good Hope Hospital in Birmingham, UK, says he was moved to write after being “disturbed once again to see an article on cardiovascular risk that totally ignores the massive evidence base linking erectile dysfunction with CV risk.” The article he refers to discussed the pros and cons of CV screening in high-risk individuals, published in the same journal earlier this year and described by MedWire News.
Hackett says that the evidence shows that erectile dysfunction gives a 2-3-year warning of myocardial infarction, and confers an increase in risk for coronary events at least comparable to that for moderate smoking or family history.
He adds that erectile dysfunction in Type 2 diabetes is a better predictor of coronary risk than hemoglobin A1c levels, hypertension, micoralbuminuria, or hyperlipidemia, and that over half of men with the Type 2 diabetes are hypogonadal, which carries a 60% increased risk for early CV death.
“Despite this evidence we don’t even screen for erectile dysfunction or low testosterone in Type 2 diabetes or patients with coronary heart disease,” Hackett laments. “We prescribe drugs for coronary heart disease that make erectile dysfunction worse, even though there are drug treatments as effective which improve it, and then make the patients pay privately because we treat erectile dysfunction as a recreational or ‘lifestyle issue’.”
In response to the letter, Judy O’Sullivan, a cardiac nurse at the British Heart Foundation (BHF), commented: “Men with erectile dysfunction should talk to their doctors about assessing their risk of cardiovascular disease and take action to address risk factors, such as high cholesterol or high blood pressure.
“Sadly, a lot of men with erectile dysfunction ignore it instead of seeking help and support. Reporting erectile dysfunction could help them to access tests and treatments that will lower their chances of having a heart attack or stroke. It could also improve their quality of life.”
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