September 2, 2014
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Studies: Erectile dysfunction, low testosterone may signal increased heart risk

You probably don't need a study to know there's a connection between men's sexual function and affairs of the heart. But new research is shedding light on the relationship between things like erectile dysfunction and testosterone levels and a man's heart health in the literal sense.

Several studies that looked at "male problems" such as difficulties achieving and maintaining erections and having low testosterone found not only that these issues can be markers for heart disease but that treating the problem could have a positive effect on heart health.

In the first of two studies presented at the American Society of Hypertension's 20th Annual Scientific Meeting and Exposition, researchers compared the rates of erectile dysfunction and high blood pressure in a group of 634 men between the ages of 31 and 65. Of the participants, 358 had high blood pressure, while the remaining 276 fell within the normal range. But while some of the men in both groups had symptoms of erectile dysfunction, 35% of the men in the high blood pressure group had problems achieving and maintaining erections, compared to just 14% of the men with normal blood pressure. And even in the group with normal blood pressure levels, there was a higher incidence of erectile dysfunction in men whose blood pressure was at the higher end of the range, a condition called prehypertension.

A separate study also presented at the meeting examined the effect of a popular medication used to treat erectile dysfunction on yet another risk factor for heart disease: aortic stiffness. Though it's a small study, research on 9 men who had been diagnosed with erectile dysfunction showed the daily use of sildenafil (Viagra®) to be more effective than a placebo at decreasing stiffness in the blood vessels.

"The drug has a beneficial long-term effect on aortic stiffness, a risk factor for isolated systolic hypertension, heart attack, stroke and coronary artery disease," the study's author, Dr. Charalambos Vlachopoulos, told a news conference.

A separate study on the erectile dysfunction drug vardenafil (Levitra®), which is of the same class of medications as sildenafil, also showed a positive effect on blood vessels, lending support to the theory that treating erectile dysfunction may be good for the heart. While more research is needed into how these medications, called PDE-5 inhibitors, work to improve blood vessel function, both problems may be caused by problems with the cells that line the blood vessels that prevent them from dilating.

Another study, meanwhile, which was published in the Journal of the American College of Cardiology, found that men with lower levels of testosterone may face a higher risk of having hardened arteries. In that study, researchers compared the artery thickness in 99 men between the ages of 40 and 70 who had symptoms of low testosterone with that of 140 men of the same age who did not have symptoms. As men age, their testosterone levels drop by an estimated 10% per decade, sometimes resulting in such symptoms as low libido, erectile dysfunction, lack of energy, increased body fat, and more. This condition is often referred to as andropause.

Using an ultrasound, researchers measured the thickness of the men's carotid artery, the main artery in the neck, which is considered a good gauge of the extent of artery thickening in the body. What they found was that artery thickness increased as testosterone levels dropped. They also found a link between artery thickness and higher levels of luteinizing hormone, which is normally involved in stimulating testosterone production in the body.

"Our findings confirm that in healthy middle-aged men, normal testosterone levels are protective against atherosclerosis (hardening of the arteries)," writes author Dr. Olli T. Raitakari in a news release.

But he emphasized that the study size was small and that further research must be done before any conclusions can be drawn. "These data indicate that controlled studies are needed to study the effects of testosterone supplementation," Dr/ Raitakari writes.

Pointing out that only 6% of the men in the study actually had both symptoms of low testosterone and measurably low levels of the hormone in their blood, Dr. Elizabeth Barret-Connor, who wrote an editorial on the study, agrees that further research is required.

"This study suggests that higher testosterone levels are associated with less atherosclerosis in the carotid arteries... On the other hand, most middle-aged men who complain of low libido, fatigue, or other complaints that go with 'andropause' symptoms don't actually have low testosterone levels," she said. "These results suggest that testosterone is not as bad for your heart as we had thought. Clinical trials of testosterone therapy will be necessary to confirm this idea."


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