Heart Disease and Erectile Dysfunction

Heart Disease & Erectile Dysfunction

 

Heart disease describes a range of conditions that affect both the heart and the blood vessels. Diseases under the heart disease umbrella include cardiac conditions such as heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects), and vascular conditions, such as coronary artery disease (CAD), among others.

They are also known as cardio-vascular diseases.

CAD is a predominant manifestation of cardiovascular disease (CVD) and a leading cause of morbidity and mortality.

Hypertension is the second major manifestation of cardiovascular disease (CVD)

It is known by majority of people that heart disease and erectile dysfunction are closely connected. Increasing scientific evidence suggests that ED is predominantly a vascular disorder. Endothelial dysfunction seems to be the common pathological process causing ED. 

Erectile dysfunction (ED) is a common disorder that affects the quality of life of many patients. It is prevalent in more than half of males aged over 60 years.

ED and CAD are highly prevalent and occur concomitantly because they share the same risk factors, including diabetes, hypertension, hyperlipidemia, obesity and smoking.

The incidence of ED is 42.0–57.0 % in men with CAD.

CVD can be used to predict the risk of ED because both conditions have the same risk factors. Conversely, ED may trigger events that further lead to CVD.

As we have seen in a previous blog article, commonly prescribed cardiovascular drugs, particularly diuretics, contribute to ED. Some newer generations beta-blockers, such as Nebivolol, seem to have an advantage over other beta-blockers when used to treat men with hypertension and ED. It has additional vasodilation effects because it stimulates endothelial release of nitric oxide (NO), resulting in relaxation of smooth muscle in the corpus cavernosum, allowing penile erection. Despite limited studies, some studies have demonstrated significant improvement in erectile function with nebivolol compared with second-generation cardio selective beta-blockers. Multiple previous studies have demonstrated a beneficial effect of angiotensin receptor blockers on erectile function and they should probably be the favored antihypertensive agents in patients with ED.

The current recommendations for all patients with ED and CVD aim to address lifestyle factors, such as exercise, smoking cessation, and healthy diet and weight reduction. These measures are likely to reduce cardiovascular risk and improve erectile function.

Guidelines recommend that phosphodiesterase type 5 (PDE5) inhibitors are the first-line drug for the treatment of ED.

Sildenafil citrate was the first oral drug approved for ED in the US.

The newer PDE5 inhibitors include vardenafil, tadalafil.

PDE5 inhibitors increase the number and duration of erections, as well as the percentage of successful sexual intercourse

Patients with ED at high risk of cardiovascular events should refrain from sexual activity until they are stable from a cardiovascular point of view. Their management should be under close supervision from a cardiologist.

This is why it is crucial to understand how these two major common conditions are related and what can you do about it.

For more information or if you have a question, to speak with a pharmacist or consult with one of our doctors, visit www.myswink.com or call at 1-866-myswink.

 

 

References:

 

 

  • Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart. 2003;89:251–3.

 

  • Giuliano F. New horizons in erectile and endothelial dysfunction research and therapies. Int J Imp Res. 2008;20:S2–S8. doi: 10.1038/ijir.2008.46

 

  • Meller SM, Stilp E, Walker CN, Mena-Hurtado C. The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease: role of metabolic factors and endovascular therapy. J Invasive Cardiol. 2013;25:313–9.

 

  • Rodriguez JJ, Al Dashti R, Schwarz ER. Linking erectile dysfunction and coronary artery disease. Int J Imp Res. 2005;17:S12–S18. doi: 10.1038/sj.ijir.3901424. 

 

  • Gupta BP, Murad MH, Clifton MM et al. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med. 2011;171:1797–803. doi: 10.1001/archinternmed.2011.440.

 

  • Kling J. From hypertension to angina to Viagra. Mod Drug Discov. 1998;1:31–8. 

 

  • Giuliano F, Jackson G, Montorsi F et al. Safety of sildenafil citrate: review of 67 double-blind placebo-controlled trials and the postmarketing safety database. Int J Clin Pract. 2010;64:240–55. doi: 10.1111/j.1742-1241.2009.02254.x. 

 

  • Kloner RA, Jackson G, Hutter AM. Cardiovascular safety update of tadalafil: retrospective analysis of data from placebo-controlled and open-label clinical trials of tadalafil with as needed, three times-per-week or once-a-day dosing. Am J Cardiol. 2006;97:1778–84. doi: 10.1016/j.amjcard.2005.12.073.

 

  • Olsson AM, Persson CA. Swedish Sildenafil Investigators Group. Efficacy and safety of sildenafil citrate for the treatment of erectile dysfunction in men with cardiovascular disease. Int J Clin Pract. 2001;55:171–6

 

  • Conti CR, Pepine CJ, Sweeney M. Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease. Am J Cardiol. 1999;83:29C–34. doi: 10.1016/S0002-9149(99)00045-4.