According to a recent report by the Princeton Consensus (Expert Panel) Conference, men’s sexual function should be evaluated and taken into account when they are being tested for risk factors of cardiovascular problems.
Lead author of the study Dr. Ajay Nehra, vice chairperson, professor and director of Men’t Health in the Department of Urology at Rush University Medical Center in Chicago, worked with over 20 other experts to determine their findings.
The study explains that erectile dysfunction (ED) is a risk factor in men younger than 55 for eventual cardiovascular disease. In some men diagnosed with ED, a cardiovascular event may occur within 2 to 5 years.
Nehra explains:
“Any man with ED should be considered at a substantially higher increase cardiovascular risk until further testing can be done. Erectile dysfunction often occurs in the presence of silent, symptomatic cardiovascular disease; and hence this is an opportunity for cardiovascular risk reduction.”
The researchers recommend that men over 30 who suffer from ED should be evaluated closely for cardiovascular disease, because they believe that any man over 30 who has ED has a large risk for CVD (cardiovascular disease).
The experts determined that men who experience ED are at twice the risk of having cardiovascular disease than men who do not have ED. The younger then men are, the higher the risk of CVD.
Recent trials have shown that low testosterone levels may be associated with ED, CVD and cardiovascular death. Therefore, the team says men should also be tested to determine their testosterone levels.
Trials of over 500 patients have shown that low levels of testosterone result in a higher risk of mortality. Nehra continues: “Testosterone levels should be routinely measured. Men with testosterone levels less than 230 have higher risk for all cause and cardiovascular mortality.” These findings, along with advice for patients with ED and CVD were been published in Mayo Clinic Proceedings in the August 2012 issue.
The goal of the Princeton III meeting, which updated data presented at Princeton I and Princeton II meetings in 2000 and 2005, was to discover a method for optimizing sexual function in men and improving cardiovascular health in patients who have CVD.
Nehra commented:
“The conference focused on the predictive value of vascular erectile dysfunction in assigning cardiovascular risk in men of all ages, the objective being development of a primary approach to cardiovascular risk assessment in younger men with erectile dysfunction and no cardiovascular disease.”
The team’s approach adds to the 2010 American College of Cardiology/American Heart Association recommendation to screen asymptomatic adults at risk of cardiovascular disease. However, this did not involve men with ED. Other studies, including the Framingham Heart Study, only include minimum information about patients under the age of 40.
“Experts have been considering the connection between erectile dysfunction and cardiovascular disease for a while. Recent data and publications about the connection have become more consistent in linking the two”, said Nehra.
Evidence of ED being linked with CVD in men under the age of 40 is rapidly growing. One trial explained that men between the ages of 40 and 49 who had ED had a 50% higher likelihood of coronary artery disease than the men who did not have the disorder.
The team notes that it would be beneficial for the cardiovascular evaluations to involve looking at blood and urine tests and lifestyle habits, as well as history of family health to determine if risk factors are present in the patient. This will assist in deciding appropriate treatment.
Nehra said: “That means that doctors treating men for erectile dysfunction can play a critical role in helping monitor and start reducing a patient’s cardiovascular risk, even when the patient has no symptoms.”
The panel recommends evaluating whether men who have ED have cardiovascular health persistent with the physical action needed for sexual activity. This is more important for men who have a very high risk of developing CVD.
The report said: “Scientific evidence suggests that a comprehensive approach to cardiovascular risk reduction will improve overall vascular health, including sexual function.”
The Princeton III team recommends that doctors ask patients, especially men older than 30, if they have any symptoms of ED.
They conclude: “Identification of ED, particularly in men younger than 60, represents an important first step toward CVD detection and reduction.”
Written by Christine Kearney