Friday, 13 April 2012

Erectile dysfunction linked to more sinister vascular disease

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erectile dysfunction“ED is thus very much a manifestation of generalised vascular endothelial disease in the penile vascular bed.”—Dr Chew. Image: Attila SzantnerVASCULOGENIC erectile dysfunction (ED) is a novel marker and predictor for future atherosclerotic cardiovascular (CV) events, new research concludes.

Senior Clinical Fellow and physician at the Keogh Institute for Medical Research Dr Kew Kim Chew says “although ED has previously been shown to have a close inter-relationship with CV disease, only recent research has produced confirmatory evidence that the two conditions are in fact manifestations of atherosclerosis from endothelial dysfunction.”

Author of the study, Dr Chew says, “In both conditions, endothelial dysfunction is affirmed by increased plasma levels of biomarkers of systemic inflammation, such as the proinflammatory cytokines interleukin-6, interleukin-8 and interleukin-18 (secreted proteins the immune system largely depends upon), as well as high sensitivity C-reactive proteins (known to rise in numbers in response to inflammation).

“ED is thus very much a manifestation of generalised vascular endothelial disease in the penile vascular bed.”

While ED can also be caused by neurological or psychological disorders, Dr Chew says vascular causes for ED are more common and says his findings apply to the majority of ED sufferers who aren’t yet aware of the CV risk they run—especially the younger men in which he observed a higher predictive value of ED for future CV risk.

“Although vasculogenic ED is more commonly seen in older men because CV risk factors become more prevalent as age advances and the absolute numbers of CV events in the study increased with age, the incidence rate ratios (IRRs) for subsequent atherosclerotic CV events were more than seven times higher in men under 40 years of age than the IRRs in men aged 70 to 79 years.

“The inference from the finding is that the risk of a CV event is many times higher if and when ED presents in younger men, and the awareness of this should lead to conscientious investigation for CV risk in these younger men with view to exclusion, prevention and minimization of such risk.”

To date, it’s estimated that 25.1 percent of West Australian men aged 20 years and older suffer from ED, while another 8.5 per cent reported suffering from severe ED.

Dr Chew says obesity is a prominent risk factor for ED and CVD and adds that regular physical activity is beneficial to both conditions. High consumption of alcohol, heavy smoking and unhealthy diets all can lead to ED.

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