Why Erectile Dysfunction Can Predict a Heart Attack

by Leigh on May 7, 2015

erectile dysfunction and coronary artery diseaseProblems in the bedroom are often a matter of the heart, but you wouldn’t necessarily link erectile dysfunction with heart attacks. There is plenty of evidence to suggest, however, that anyone experiencing erectile dysfunction ought to seek medical attention to ensure that this isn’t an early sign of cardiovascular disease.

Erectile dysfunction (ED) has been called a harbinger for coronary artery disease, because a body that struggles to pump blood through blocked arteries can also struggle to get enough blood to penile tissue to achieve and maintain an erection. The penile arteries are 1-2 mm wide and the coronary arteries are 3-4 mm wide, meaning that narrowing of the arteries is more likely to show up as erectile dysfunction before it manifests as overt coronary artery disease.

Patients presenting with ED should be given a full cardiovascular work-up, including checking their blood pressure, blood lipids, exercise regimen, and diet. Assessing these patients for diabetes and metabolic syndrome is also important in order to ensure that any treatment not only aims to resolve ED, but also supports heart health.

CAD Risk 40-50 Times Higher in Men with Erectile Dysfunction

The statistics from a major meta-analysis show that a 70-year-old man experiencing ED has 1.4 times the risk of coronary artery disease than a man of the same age without ED. For a 40-year-old man, the increase in risk is some 40-50 times.

Men experiencing ED are often reluctant to seek medical attention, while younger men may have the symptom dismissed as caused by stress or fatigue. The research suggests that it is essential to fully assess erectile dysfunction in order to rule out serious underlying health concerns, before simply prescribing rest and/or counselling.

ED Predicts CAD 3-5 Years Later

There are some important things for physicians to consider when assessing a patient with ED, such as the longevity of the symptoms. This is because ED tends to precede coronary artery disease by about 3-5 years, so anyone with ED for a couple of years should be checked for cardiovascular problems right away. For both younger and older patients, the results of these tests can help motivate them to adopt heart healthy habits to reduce their risk factors.

Physicians working with men who are at risk for cardiovascular disease are increasingly taught to ask about erectile dysfunction, with those who report such problems then able to be more closely assessed and treated where necessary. Early and aggressive intervention can significantly reduce the chances of serious heart problems later on in life.

Improving Erectile Function

Patients with ED who are overweight, sedentary, and who eat a poor diet can often improve their cardiovascular health and overcome difficulties in achieving and maintaining an erection by becoming more active, losing a little weight to reduce body fat, and eating a diet rich in antioxidants, anti-inflammatory nutrients, and that is low in sugars and refined carbohydrates.

The same meta-analysis mentioned above found that if patients lost some weight and got their risk factors under control the results were equivalent to taking 25 mg of Viagra for ED. Ironically, some of the drugs used to treat erectile dysfunction can have adverse consequences for heart health. Symptoms such as abnormal heart rhythm or lightheadedness after sex can be suggestive of too much stress on the heart and even the development of hypertrophic cardiomyopathy.

There has been some success with using stents to hold the arteries open and improve blood flow to resolve ED. More commonly, lifestyle and dietary changes are recommended in order to improve all-round cardiovascular and metabolic health. One such recommendation is to eat a whole food plant-based diet, which is higher in fibre, lower in sugar and saturated fat, and which provides plentiful antioxidants to help prevent damage to the arteries and blood vessels.


Gupta BP, Murad NH, Clifton MM, Prokop L, Nehra A, Kopecky SL. (2011). The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: A systematic review and meta-analysis. Arch Intern Med, 171:1797-1803.

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