Erectile dysfunction and heart disease

Erectile dysfunction and heart disease are closely linked, and if you or someone you know has ED, it is important to see a doctor for cardiovascular screening.

ED affects millions of men worldwide. Back in 2000, ED researcher Dr. Goldstein sought to identify whether or not ED, cardiovascular disease and depression all share mutually reinforcing predictors and associations. He analyzed studies for specific variables such as heart disease, age, sedentary behavior and cigarette smoking.

He found all of these variables had a direct correlation with depressive symptoms, erectile dysfunction and heart disease, and all three conditions shared many of the same risk factors.

ED is a common disorder and recent data predict it will become even more common over the next few years. Defined as the inability to achieve and maintain an erection, ED affects aging men. A man aged 70 years is three times more likely to have ED than a man aged 40 years. As well as an increase in ED itself, experts predict an increase in the prevalence of risk factors for ED, such as hypertension, hyperlipidemia, and benign prostatic hyperplasia among the elder population.

Heart disease

Cardiovascular disease is the primary, independent risk factor for ED. Many studies show a direct correlation between erectile dysfunction and heart disease. Lifestyle factors such as smoking, lack of exercise and obesity will increase your risk for heart disease (Carson, 2004).

To investigate if ED was a predictor of upcoming cardiovascular episodes and death in patients with diabetes and silent coronary artery disease (CAD), researchers Gazaruso and colleagues (2008) conducted a meta-analysis.

They were looking for predictors of cardiovascular events and death among patients with CAD, diabetes and ED. Men with ED were assessed with the International Index of Erectile Function (IIEF) questionnaire, which was developed in 1999 as a tool of screening for ED.

During follow-up, 49 patients experienced major adverse cardiac events. The scientists concluded that ED is a powerful forecaster of cardiovascular morbidity and mortality for people with diabetes and silent CAD. They also found that treatment with lipid-lowering agents, known as statins, and phosphodiesterase enzyme inhibitors such as sildenafil (Viagra) may reduce the occurrence of cardiovascular events among patients with diabetes, erectile dysfunction and heart disease.

High cholesterol

ED is also linked to high cholesterol (hyperlipidemia), with over 60% of men with ED having high cholesterol. Elevated cholesterol levels leads to arterial occlusion, and around 90% of men with ED show penile arterial disease on Doppler ultrasonography (Solomon et al., 2002).

If you have ED, be sure to keep regular checks on your cholesterol levels, especially as hyperlipidemia has no visible signs and symptoms that would alert you to the condition.


If you have ED, you should ask your doctor to screen you for depression. Some of the symptoms of depression include sadness, loss of interest in usual things, anxiety, change in appetite and sleeping problems. Many factors can lead to depression including relationship changes, bereavement, advancing age, chronic illnesses and obesity.

Many studies confirm that depression is directly associated with ED. The Massachusetts Male Aging Study found depression was the second most common risk factor for ED.

Further, a side effect of many medications that treat depression is ED. Selective serotonin reuptake inhibitor (SSRI) antidepressant drugs such as Prozac cause the majority of sexual dysfunction. You can eliminate associated with these medications by taking bupropion. Another option is to stop the SSRI altogether and try another medication.

Many who have both ED and depression find that Viagra works well for them (Carson, 2004).


Another commonly associated condition related to ED is diabetes mellitus. Approximately 50% of men with diabetes develop erectile function problems, so if you have ED, make sure your doctor carries out regular glucose checks on your blood. This is particularly important if you have a family history of diabetes.


  • Carson, C.C. (2004). Erectile dysfunction: evaluation and new treatment options. Psychosomatic Medicine, 66(5): 664 – 671. doi: 10.1097/​01.psy.0000133969.80612.7
  • Gazzaruso, C. et al. (2008). Erectile dysfunction as a predictor of cardiovascular events and death in diabetic patients with angiographically proven asymptomatic coronary artery disease. Journal of American College of Cardiology, 51(21): 2040 – 2044.
  • Goldstein, I. (2000). The mutually reinforcing triad of depressive symptoms, cardiovascular disease, and erectile dysfunction. The American Journal of Cardiology, 86(2): 41 -45.
  • Rosen, J.C., Cappelleri, J.C., Smith, M.D., Lipsky, J., & Pena, B.M., (1999). Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research, 319 – 326.
  • Solomon, H., Man, J.W., & Jackson, G. (2002). Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart, 89, 251 – 253. doi:10.1136/heart.89.3.251

Last reviewed 03/Jun/2017


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