Because penile arteries are only about half the size of the coronary arteries in the heart, erectile dysfunction can be a powerful predictor of cardiac events—such as sudden death.
Survival of the Firmest: Erectile Dysfunction and Death
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Erectile dysfunction…[is] defined as the recurrent or persistent inability to attain and/or maintain an erection in order for satisfactory sexual performance.” It is “present in up to 30 million men in the U.S. and approximately 100 million men worldwide.” Wait a second. The U.S. has less than 8% of the world’s population, yet up to 30% of the impotence? We’re #1!
Who cares, though? We’ve got red, white, and blue pills, like Viagra. The problem, though, is the pills just cover up the symptoms of vascular disease, and don’t do anything for the underlying pathology. Erectile dysfunction and our #1 killer, coronary artery disease, are just two “Manifestations of the Same Disease”—inflamed, clogged, and crippled arteries—regardless of which organ.
Atherosclerosis is considered “a systemic disorder that uniformly affects all major [blood vessels in the body.]” Hardening of the arteries can lead to softening of the penis, because stiffened arteries can’t relax normally, open wide, and let the blood flow. So, erectile dysfunction may just be the flaccid “tip of [an] iceberg,” in terms of a “systemic…disorder.” In two-thirds of men showing up to emergency rooms for the first time with crushing chest pain, their penis had been trying to warn them for years that something was wrong with their circulation.
Why does it tend to hit the penis first? Because the penile arteries in the penis are half the size of the coronary arteries in our heart—that particular artery is the so-called widowmaker. So, the same amount of plaque in the heart, that you wouldn’t even feel, could half clog the penile artery, causing a symptomatic restriction in blood flow. You may not feel chest pain until about here. That’s why erectile dysfunction has been called “penile angina.” In fact, by measuring blood flow in a man’s penis, you can predict the results of his cardiac stress test with an accuracy of 80%. “[M]ale sexual function [is like a] penile stress test…[,] a ‘window to the hearts of men.'”
“40% of men over 40” have erectile dysfunction. Men getting erection difficulties in their 40s have a 50-fold increased risk of having a cardiac event—like sudden death.
You’ve heard me say various things, you know, increase heart disease risk 20%, 30%. That’s nearly 5,000%, leading the latest review to ask: “is there any risk greater?” That’s because it’s not so much a risk factor for atherosclerosis; it is atherosclerosis.
A man with erectile dysfunction (even if he has “no cardiac symptoms) should be considered a cardiac…patient until proved otherwise.” It’s considered to be a “cardiac equivalent,” right? It’s a marker of the coronary artery disease you likely already have. “There is therefore more to treating [erectile dysfunction] than just establishing an erect penis, as [it] offers an opportunity for reducing cardiovascular risk.
The reason that even young men should care about their cholesterol is because it predicts erectile dysfunction later in life. And, that predicts heart attacks, strokes, and a shortened lifespan. Just going to keep eating crap because you can pop some pills? All the Viagra in the world may not help your sex life, after a stroke. The take-home message is a simple equation: ED stands for “early death.”
Please consider volunteering to help out on the site.
- S.-D. Chung, Y.-K. Chen, H.-C. Lin, H.-C. Lin. Increased risk of stroke among men with erectile dysfunction: A nationwide population-based study. J Sex Med 2011 8(1):240 - 246.
- B. G. Schwartz, R. A. Kloner. How to save a life during a clinic visit for erectile dysfunction by modifying cardiovascular risk factors. Int. J. Impot. Res. 2009 21(6):327 - 335.
- F. Yao, Y. Huang, Y. Zhang, Y. Dong, H. Ma, C. Deng, H. Lin, D. Liu, K. Lu. Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. Int. J. Androl. 2012 35(5):653 - 659.
- G. Corona, G. Fagioli, E. Mannucci, A. Romeo, M. Rossi, F. Lotti, A. Sforza, S. Morittu, V. Chiarini, G. Casella, G. Di Pasquale, E. Bandini, G. Forti, M. Maggi. Penile doppler ultrasound in patients with erectile dysfunction (ED): Role of peak systolic velocity measured in the flaccid state in predicting arteriogenic ED and silent coronary artery disease. J Sex Med 2008 5(11):2623 - 2634.
- K.-K. Chew, N. Gibson, F. Sanfilippo, B. Stuckey, A. Bremner. Cardiovascular mortality in men with erectile dysfunction: Increased risk but not inevitable. J Sex Med 2011 8(6):1761 - 1771.
- B. P. Gupta, M. H. Murad, M. M. Clifton, L. Prokop, A. Nehra, S. L. Kopecky. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: A systematic review and meta-analysis. Arch. Intern. Med. 2011 171(20):1797 - 1803.
- K. Esposito, M. Ciotola, F. Giugliano, M. De Sio, G. Giugliano, M. D'armiento, D. Giugliano. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int. J. Impot. Res. 2006 18(4):405 - 410.
- K. Esposito, F. Giugliano, M. I. Maiorino, D. Giugliano. Dietary factors, Mediterranean diet and erectile dysfunction. J Sex Med 2010 7(7):2338 - 2345.
- F. Giugliano, M. I. Maiorino, C. Di Palo, R. Autorino, M. De Sio, D. Giugliano, K. Esposito. Adherence to Mediterranean diet and sexual function in women with type 2 diabetes. J Sex Med 2010 7(5):1883 - 1890.
- D. R. Meldrum, J. C. Gambone, M. A. Morris, D. A. N. Meldrum, K. Esposito, L. J. Ignarro. The link between erectile and cardiovascular health: The canary in the coal mine. Am. J. Cardiol. 2011 108(4):599 - 606.
- K. Esposito, M. Ciotola, F. Giugliano, B. Schisano, R. Autorino, S. Iuliano, M. T. Vietri, M. Cioffi, M. De Sio, D. Giugliano. Mediterranean diet improves sexual function in women with the metabolic syndrome. Int. J. Impot. Res. 2007 19(5):486 - 491.
- K. Esposito, D. Giugliano. Lifestyle/dietary recommendations for erectile dysfunction and female sexual dysfunction. Urol. Clin. North Am. 2011 38(3):293 - 301.
- E. Chiurlia, R. D'Amico, C. Ratti, A. R. Granata, R. Romagnoli, M. G. Modena. Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J. Am. Coll. Cardiol. 2005 46(8):1503 - 1506.
- P. Montorsi, P. M. Ravagnani, S. Galli, F. Rotatori, A. Briganti, A. Salonia, P. Rigatti, F. Montorsi. The artery size hypothesis: A macrovascular link between erectile dysfunction and coronary artery disease. Am. J. Cardiol. 2005 96(12B):19M - 23M.
- G. Jackson. Erectile dysfunction and coronary disease: Evaluating the link. Maturitas 2012 72(3):263 - 264.
- M. M. Fung, R. Bettencourt, E. Barrett-Connor. Heart disease risk factors predict erectile dysfunction 25 years later: The Rancho Bernardo Study. J. Am. Coll. Cardiol. 2004 43(8):1405 - 1411.
- J.-Y. Dong, Y.-H. Zhang, L.-Q. Qin. Erectile dysfunction and risk of cardiovascular disease: Meta-analysis of prospective cohort studies. J. Am. Coll. Cardiol. 2011 58(13):1378 - 1385.
- K. Esposito, D. Giugliano. Lifestyle for erectile dysfunction: A good choice. Arch. Intern. Med. 2012 172(3):295 - 296.
- G. Jackson. Problem solved: Erectile dysfunction (ED) = early death (ED). Int. J. Clin. Pract. 2010 64(7):831 - 832.
- F. Montorsi, A. Briganti, A. Salonia, P. Rigatti, A. Margonato, A. Macchi, S. Galli, P. M. Ravagnani, P. Montorsi. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur. Urol. 2003 44(3):360 - 364.
- P. Montorsi, F. Montorsi, C. C. Schulman. Is erectile dysfunction the tip of the iceberg of a systemic vascular disorder? Eur. Urol. 2003 44(3):352 - 354.
- Inman BA1, Sauver JL, Jacobson DJ, McGree ME, Nehra A, Lieber MM, Roger VL, Jacobsen SJ. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc. 2009 84(2):108-13.
Thanks to Ellen Reid, Maxim Fetissenko, PhD, and Laurie-Marie Pisciotta for their Keynote help.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Erectile dysfunction…[is] defined as the recurrent or persistent inability to attain and/or maintain an erection in order for satisfactory sexual performance.” It is “present in up to 30 million men in the U.S. and approximately 100 million men worldwide.” Wait a second. The U.S. has less than 8% of the world’s population, yet up to 30% of the impotence? We’re #1!
Who cares, though? We’ve got red, white, and blue pills, like Viagra. The problem, though, is the pills just cover up the symptoms of vascular disease, and don’t do anything for the underlying pathology. Erectile dysfunction and our #1 killer, coronary artery disease, are just two “Manifestations of the Same Disease”—inflamed, clogged, and crippled arteries—regardless of which organ.
Atherosclerosis is considered “a systemic disorder that uniformly affects all major [blood vessels in the body.]” Hardening of the arteries can lead to softening of the penis, because stiffened arteries can’t relax normally, open wide, and let the blood flow. So, erectile dysfunction may just be the flaccid “tip of [an] iceberg,” in terms of a “systemic…disorder.” In two-thirds of men showing up to emergency rooms for the first time with crushing chest pain, their penis had been trying to warn them for years that something was wrong with their circulation.
Why does it tend to hit the penis first? Because the penile arteries in the penis are half the size of the coronary arteries in our heart—that particular artery is the so-called widowmaker. So, the same amount of plaque in the heart, that you wouldn’t even feel, could half clog the penile artery, causing a symptomatic restriction in blood flow. You may not feel chest pain until about here. That’s why erectile dysfunction has been called “penile angina.” In fact, by measuring blood flow in a man’s penis, you can predict the results of his cardiac stress test with an accuracy of 80%. “[M]ale sexual function [is like a] penile stress test…[,] a ‘window to the hearts of men.'”
“40% of men over 40” have erectile dysfunction. Men getting erection difficulties in their 40s have a 50-fold increased risk of having a cardiac event—like sudden death.
You’ve heard me say various things, you know, increase heart disease risk 20%, 30%. That’s nearly 5,000%, leading the latest review to ask: “is there any risk greater?” That’s because it’s not so much a risk factor for atherosclerosis; it is atherosclerosis.
A man with erectile dysfunction (even if he has “no cardiac symptoms) should be considered a cardiac…patient until proved otherwise.” It’s considered to be a “cardiac equivalent,” right? It’s a marker of the coronary artery disease you likely already have. “There is therefore more to treating [erectile dysfunction] than just establishing an erect penis, as [it] offers an opportunity for reducing cardiovascular risk.
The reason that even young men should care about their cholesterol is because it predicts erectile dysfunction later in life. And, that predicts heart attacks, strokes, and a shortened lifespan. Just going to keep eating crap because you can pop some pills? All the Viagra in the world may not help your sex life, after a stroke. The take-home message is a simple equation: ED stands for “early death.”
Please consider volunteering to help out on the site.
- S.-D. Chung, Y.-K. Chen, H.-C. Lin, H.-C. Lin. Increased risk of stroke among men with erectile dysfunction: A nationwide population-based study. J Sex Med 2011 8(1):240 - 246.
- B. G. Schwartz, R. A. Kloner. How to save a life during a clinic visit for erectile dysfunction by modifying cardiovascular risk factors. Int. J. Impot. Res. 2009 21(6):327 - 335.
- F. Yao, Y. Huang, Y. Zhang, Y. Dong, H. Ma, C. Deng, H. Lin, D. Liu, K. Lu. Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. Int. J. Androl. 2012 35(5):653 - 659.
- G. Corona, G. Fagioli, E. Mannucci, A. Romeo, M. Rossi, F. Lotti, A. Sforza, S. Morittu, V. Chiarini, G. Casella, G. Di Pasquale, E. Bandini, G. Forti, M. Maggi. Penile doppler ultrasound in patients with erectile dysfunction (ED): Role of peak systolic velocity measured in the flaccid state in predicting arteriogenic ED and silent coronary artery disease. J Sex Med 2008 5(11):2623 - 2634.
- K.-K. Chew, N. Gibson, F. Sanfilippo, B. Stuckey, A. Bremner. Cardiovascular mortality in men with erectile dysfunction: Increased risk but not inevitable. J Sex Med 2011 8(6):1761 - 1771.
- B. P. Gupta, M. H. Murad, M. M. Clifton, L. Prokop, A. Nehra, S. L. Kopecky. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: A systematic review and meta-analysis. Arch. Intern. Med. 2011 171(20):1797 - 1803.
- K. Esposito, M. Ciotola, F. Giugliano, M. De Sio, G. Giugliano, M. D'armiento, D. Giugliano. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int. J. Impot. Res. 2006 18(4):405 - 410.
- K. Esposito, F. Giugliano, M. I. Maiorino, D. Giugliano. Dietary factors, Mediterranean diet and erectile dysfunction. J Sex Med 2010 7(7):2338 - 2345.
- F. Giugliano, M. I. Maiorino, C. Di Palo, R. Autorino, M. De Sio, D. Giugliano, K. Esposito. Adherence to Mediterranean diet and sexual function in women with type 2 diabetes. J Sex Med 2010 7(5):1883 - 1890.
- D. R. Meldrum, J. C. Gambone, M. A. Morris, D. A. N. Meldrum, K. Esposito, L. J. Ignarro. The link between erectile and cardiovascular health: The canary in the coal mine. Am. J. Cardiol. 2011 108(4):599 - 606.
- K. Esposito, M. Ciotola, F. Giugliano, B. Schisano, R. Autorino, S. Iuliano, M. T. Vietri, M. Cioffi, M. De Sio, D. Giugliano. Mediterranean diet improves sexual function in women with the metabolic syndrome. Int. J. Impot. Res. 2007 19(5):486 - 491.
- K. Esposito, D. Giugliano. Lifestyle/dietary recommendations for erectile dysfunction and female sexual dysfunction. Urol. Clin. North Am. 2011 38(3):293 - 301.
- E. Chiurlia, R. D'Amico, C. Ratti, A. R. Granata, R. Romagnoli, M. G. Modena. Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J. Am. Coll. Cardiol. 2005 46(8):1503 - 1506.
- P. Montorsi, P. M. Ravagnani, S. Galli, F. Rotatori, A. Briganti, A. Salonia, P. Rigatti, F. Montorsi. The artery size hypothesis: A macrovascular link between erectile dysfunction and coronary artery disease. Am. J. Cardiol. 2005 96(12B):19M - 23M.
- G. Jackson. Erectile dysfunction and coronary disease: Evaluating the link. Maturitas 2012 72(3):263 - 264.
- M. M. Fung, R. Bettencourt, E. Barrett-Connor. Heart disease risk factors predict erectile dysfunction 25 years later: The Rancho Bernardo Study. J. Am. Coll. Cardiol. 2004 43(8):1405 - 1411.
- J.-Y. Dong, Y.-H. Zhang, L.-Q. Qin. Erectile dysfunction and risk of cardiovascular disease: Meta-analysis of prospective cohort studies. J. Am. Coll. Cardiol. 2011 58(13):1378 - 1385.
- K. Esposito, D. Giugliano. Lifestyle for erectile dysfunction: A good choice. Arch. Intern. Med. 2012 172(3):295 - 296.
- G. Jackson. Problem solved: Erectile dysfunction (ED) = early death (ED). Int. J. Clin. Pract. 2010 64(7):831 - 832.
- F. Montorsi, A. Briganti, A. Salonia, P. Rigatti, A. Margonato, A. Macchi, S. Galli, P. M. Ravagnani, P. Montorsi. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur. Urol. 2003 44(3):360 - 364.
- P. Montorsi, F. Montorsi, C. C. Schulman. Is erectile dysfunction the tip of the iceberg of a systemic vascular disorder? Eur. Urol. 2003 44(3):352 - 354.
- Inman BA1, Sauver JL, Jacobson DJ, McGree ME, Nehra A, Lieber MM, Roger VL, Jacobsen SJ. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc. 2009 84(2):108-13.
Thanks to Ellen Reid, Maxim Fetissenko, PhD, and Laurie-Marie Pisciotta for their Keynote help.
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Survival of the Firmest: Erectile Dysfunction and Death
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Content URLDoctor's Note
Thankfully, Our #1 Killer Can Be Stopped. Check out my video on Eliminating the #1 Cause of Death. More background can be found in Arterial Acne and Blocking the First Step of Heart Disease.
This is the first video of a three-part series on sexual health. Stay tuned for 50 Shades of Greens, and Pistachio Nuts for Erectile Dysfunction.
Previous videos on this topic include:
- Rosy Glow
- Atkins Diet: Trouble Keeping It Up
- BPA Plastic & Male Sexual Dysfunction
- Watermelon as Treatment for Erectile Dysfunction
A similar relationship appears to exist for female sexual function as well: Cholesterol & Female Sexual Dysfunction.
2018 Update: Check out my more recent videos on the subject – Viagra & Cancer and Saffron for Erectile Dysfunction.
For further context, check out my associated blog posts: Top 10 Most Popular Videos of 2013, Foods for a Long Life & Love Life, Pills vs. Diet for Erectile Dysfunction, and Pistachios May Help Erectile Dysfunction.
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