Erectile dysfunction"”Red flag for heart disease?

Health Professional

As far apart as they seem, erectile dysfunction (ED) and heart disease all too frequently go together. Where you find one, you'll often find the other.

In fact, ED, formerly known as "impotence," is so closely tied to heart disease that it should rank alongside high cholesterol, high blood pressure, smoking, and diabetes as prominent indicators of potential heart disease.

The 2006 COBRA study in men with advanced coronary disease showed that an astounding 93% experienced ED.

At the other end of the spectrum are men with risk factors for heart disease like high blood pressure, low HDL cholesterol, or high LDL cholesterol, or have coronary plaque as detected by a heart scan (signifying early heart disease but not causing symptoms like chest pain or breathlessness). How many men who simply have a heart scan score positive to any degree (meaning any score >0) have ED? Around 50%.

Only in the last few years have the rules of conversation loosened sufficiently to even talk about ED out in the open. But today you can even see sports celebrities talking about it in TV commercials.

The conversation about ED really gained momentum with the development of ED-drugs like Viagra ® and Cialis ®.

Why would such two seemingly unrelated conditions like heart disease and ED be such frequent bedfellows? Coronary disease is characterized by a dysfunctional state of the "endothelium," or inner lining of the arteries. Erectile dysfunction is, likewise, characterized by dysfunction of the endothelium of the penile circulation. Same phenomenon, different territories.

The lesson to take from this curious connection: If you or a loved one has ED, then a search for hidden heart disease should be considered. (In my view, a heart scan should be the place to start, the easiest, most widely available, low-radiation, low-cost method to detect hidden coronary heart disease). If hidden heart disease is present, a preventive program needs to be initiated. Doing so will help reduce risk of heart attack. It might even improve your sex life.

If you or a loved one have heart disease, then ED is likely to follow in its wake-all the more reason to engage in an effective program of heart disease prevention. Perhaps improvement in the situation that led to both heart disease and ED in the first place will follow.

A nutritional supplement for ED?

If you surf the 'net, you'll find plenty of advice on how to improve or "cure" ED. There's lots of misinformation. But there's also some truth.

One of the most helpful and specific nutritional supplements available that can partially reverse the endothelial dysfunctional state of ED is l-arginine. L-arginine is the body's source of nitric oxide (NO), the master dilator (relaxing agent) for all arteries of the body. NO dilates penile arteries, it dilates coronary arteries. Lack of NO disables penile capacity for erection and encourages growth of coronary atherosclerotic plaque.

If you have any doubts about the physiologic effects of the supplement, l-arginine, just give it a try if you have erectile dysfunction. The erection-enhancing effects alone should convince you that a genuine artery-dilating effect is exerted by this very powerful nutritional supplement. (Male patients usually report positive effects with 3000 mg twice per day, ideally taken on an empty stomach. Occasionally, higher doses of up to 6000 mg twice per day are necessary; doses this high are best taken as a powder preparation). The effect may require several weeks to develop.

If l-arginine fails by itself to restore full erectile capacity, there are additional strategies, both nutritional and medical, that you can consider. That's when you will need to work with your doctor.