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By Denise MannMONDAY, March 15, 2010 (Health.com) — Men with cardiovascular disease and erectile dysfunction (ED) are almost twice as likely to die in a given time period than similar men the same age who do not have trouble achieving or maintaining an erection, a new study suggests.

What’s more, men with ED are twice as likely to have a heart attack, have a 20% greater chance of being hospitalized due to heart failure, and have a 10% increased risk for stroke, compared with men who do not have erectile dysfunction, according to the study of male cardiovascular disease patients in the March 30 issue of Circulation: Journal of the American Heart Association.

While ED can be due to injury, medication side effects, and psychological factors, it also may be sign of a lack of blood flow due to arterial disease, which could signal trouble in other parts of the body, such as the heart and brain.

If you have problems achieving or maintaining an erection, talk to your doctor, says R. Parker Ward, MD, an associate professor of medicine at the University of Chicago Medical Center. “Increasingly, physicians are recognizing that erectile dysfunction is a risk factor for heart disease, and if you have it, they will be a little more aggressive in treating your traditional heart disease risk factors such as high cholesterol, and encouraging exercise and eating well,” says Dr. Ward, who was not involved in the study.

But don't panic yet: Just because you have ED does not mean that you have heart disease. “There are other non-vascular causes of ED,” says Dr. Ward. “A young man without other heart disease risk factors may have ED as a result of psychological issues.”

Next page: More than half of the men had ED

The new study combined data from 1,519 men in 13 countries who were enrolled in two different studies—the Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET) and the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease (TRANSCEND). The men, who had a history of stroke, heart attack, diabetes, or other signs of cardiovascular disease, answered questionnaires about their sexual function.

Overall, 55% of the men had ED when they were enrolled in the two studies—a figure that is twice as high as men in the general population, according to the research team led by Michael Böhm, MD, of the University of Saarland, Germany.

Those men with ED were about two years older than men without ED, the study showed. In addition, men with ED also were more likely to have high blood pressure, diabetes, and a history of surgery in their lower urinary tract area as well as a history of stroke than were the men without ED.

Overall, 11.3% of men with erectile dysfunction died during the study, compared with 5.6% of those men who did not have erectile dysfunction.

The more significant the ED, the greater a man’s risk of heart attack, stroke, death, or other outcomes, the study showed. Men in the studies were taking medications to lower their blood pressure, and while these medications did have an effect on overall heart risk, they did not help treat ED.

“We don’t have clear evidence about what treatments we should use to lower heart risks in men with ED, but we do know that a lot of preventative therapies do work in patients with other heart disease risk factors,” says Dr. Ward. “ED will identify a person who is at higher risk and cause physicians to be a little more aggressive and keep their other heart risks as low as possible.”

Ken Fujise, MD, the chief of cardiology at the University of Texas Medical Branch, in Galveston, agrees.

“Erectile dysfunction is serious and can be one of the manifestations of cardiovascular disease,” he says. "It can be a sign of vascular insufficiency to the genital area. If you have ED, make sure your heart gets checked out.”

Improving your overall vascular health can help prevent and/or treat ED and heart disease, he says.

“If you take steps to lower your cholesterol, eat healthier, exercise regularly, and get your diabetes under control, if you happen to have diabetes, you are not only protecting your heart against heart attack, but you are protecting yourself against ED too,” he explains.

There are several medications available to treat ED, but if those don’t work and the arteries that supply blood to the penis are, in fact, blocked, surgery can open these arteries, he says.