perfusion imaging -- the portion of the test that measures blood flow to the heart. Forty-three percent of men with ED, compared to 17 percent of tested men without ED, had a myocardial perfusion summed stress score greater than eight, which is "strongly associated with clinically significant obstructive coronary artery disease and a high risk of both cardiac death and nonfatal myocardial infarction," note the authors.

Erectile dysfunction does not cause heart disease, they caution, but it may indicate that the process of arterial damage is well under way.

The risk factors for ED and coronary artery disease are similar, including obesity, diabetes, hypertension, smoking and hyperlipidemia. "As the penile arteries are relatively small in comparison with the coronary arteries," the authors write, "they may be more prone to cause ED with even comparatively small amounts of atherosclerosis."

They caution that there are a number of potential causes for erectile dysfunction, including emotional or psychological components which may not be associated with heart disease. Nonetheless, "the fact that heart disease and ED are linked biologically should come as no surprise," Ward said.

This paper has two important clinical implications, Ward said.

"First, our study identifies a group with a high prevalence of ED, and thus increased communication about this sensitive topic between patients and physicians may lead to increased treatments and improved quality of life for these patients."

"Second, asking patients about their sexual function may help identify those at risk for significant heart disease, allowing physicians to stratify that risk with further testing, and get them engaged in an aggressive program of risk-factor modification or treatment."

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Contact: John Easton
john.easton@uchospitals.edu
773-702-6241
University of Chicago Medical Center
23-Jan-2006

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