Many people who suffer a heart attack had never had any symptoms of heart disease. Of the roughly 5,000 individuals who die of sudden cardiac arrest in Sweden each year, two thirds had not had any known heart disease. But in men there is one thing that should constitute a advance sign of coming heart problems: impotence.

In some cases, impotence can have neurological, psychiatric, and other causes. But the most common cause, accounting for up to four cases of five, is that the blood circulation in the penis has become so poor that erection is impaired, or no erection can occur at all. And if the circulation in these vessels has been affected by atherosclerosis, then it is highly probable that the same process is under way in the coronary artery in the heart.

In a dissertation from Lund University in Sweden, the physician Rasmus Borgquist has managed to show that this reasoning is correct.

"One of our studies shows that otherwise healthy men with impotence show signs of early atherosclerosis in the coronary arteries of the heart. In another study we saw that men with impotence evince a higher incidence of high blood pressure, high blood fat, abdominal fat, and other traditional risk factors for heart disease," he says.

The conclusion is that men with impotence problems should seek care as soon as possible, since both their impotence and the possible threat of heart disorders can be counteracted with early intervention. The first priority involves changes in life style, such as quitting smoking, exercise, and altered diet, and then if these are insufficient, medication for lowering blood pressure and blood fat and also pharmacological therapy for treatment of the impotence as such.

"It's probably easier to get men to accept changes in their life style if you can point out that they alleviate impotence, rather than talking about the risk of a heart attack sometime down the road. And there are studies that show that potency improves rather quickly in those who quit smoking and lose weight," says Rasmus Borgquist.

The notion that there is a connection between impotence and heart disease was put forward in the mid 1980s. But this connection has been studied seriously only in recent years.

"Today there is a greater interest in these issues, both among the public and at drug companies," claims Rasmus Borgquist. "On the one hand, several new drugs have appeared to combat cardiovascular diseases and their risk factors, and, on the other hand, potency drugs like Viagra, Cialis, and Levitra have led many more men to seek help for impotence."

There is still a certain "awkwardness factor" that makes some patients reluctant to seek help, and some physicians are hesitant to take up the matter. But in Rasmus Borgquist's experience, once the physician has broached the subject, patients tend to respond frankly.

VETENSKAPSRÅDET (THE SWEDISH RESEARCH COUNCIL)
Regeringstgatan 56
103 78 Stockholm
vr.se

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