ERECTILE DYSFUNCTION, A MINOR CORONARY RISK FACTOR

There have been a strong impression that premature erectile dysfunction, from non-testicular hormonal causes may be associated with a higher risk of Coronary Artery Disease over the next 10 years. The increase risk starts at about age 40 years, and falls thereafter to become negligible by age 70 and above. This was again highlighted by a study carried out by Dr Inman of Mayo Clinic and published in the Feb 2009 issue of the Mayo Clinic Proceedings. He followed 1402 subjects from age 40-70 years who have two yearly male sexual function questionnaire. This is a longitudinal study since 1990. This are males with no overt heart disease at the start and who had normal testicular function. They have published their first ten year findings. They found that you happen to have ED at 40 years, you are 2.4 times more likely to have coronary artery disease, and the incidence drops until you are about population risk when you are 70years. There were two other previous studies that showed very much the same findings.
I suppose the explanantion may have to do with premature atherosclorosis of the little penile artery, as a manifestation of generalised atherosclerosis. Maybe there is some hormonal deficiency too. The presence of diabetes is also a strong predisposing cause. I not routinely ask about ED and sexual dysfunction in my clinical practice. Maybe I should start.
The logical conclusion would be that males at 40 yrs with ED should also get a stress ECG, as a workup towards the presence of coronary artery disease.