If you have insulin-dependent diabetes for 50 years or more and are having problems with erection, you might want to get your heart checked.A new study at Joslin Diabetes Center, Boston, indicated that a history of erectile dysfunction is independently associated with cardiovascular disease in people with type-1 diabetes. This means that erectile dysfunction can predict the onset of cardiovascular disease in people who have type-1 diabetes for 50 or more years. Erectile dysfunction (ED) may be due to inability of penile smooth muscles to relax because of inadequate nitric oxide. Nitric oxide signals the smooth muscle cells in the blood vessels to relax and dilate, so that blood flows more freely.
Atherosclerosis is a condition where blood supply to a particular part is obstructed due to formation of a plaque in the vessel. Plaque formation in the heart could lead to a heart attack, whereas plaque formation in the brain could lead to stroke. The smaller blood vessels in the penis are among the first to get plugged up in case of atherosclerosis. The plaque reduces blood flow in the penis, making an erection difficult. So, erectile dysfunction is an alert to look for plaque in larger arteries supplying the heart and other organs.
"In general, the vessels involved in erectile dysfunction have a smaller diameter, and tend to be affected by mechanisms of endothelial dysfunction earlier than larger vessels found in the heart, so this could be a predictor of cardiovascular disease," explained the author Sara Turek, study coordinator for the Medalist program at Joslin. In Joslin Medalist Program, medals are awarded to people living with insulin-dependent diabetes for 25, 50, or 75 years or more.
The Joslin study involved examination of approximately 300 men who completed questionnaires including a question regarding sexual dysfunction.
Seventy percent of the participants reported experiencing sexual dysfunction over their lifetime.
The main finding showed that sexual dysfunction is associated with cardiovascular disease without being mediated by other identified risk factors. Other risk factors for cardiovascular disease associated with diabetes include high LDL cholesterol levels, low HDL cholesterol levels, elevated body mass index (BMI), poor glycemic control, high blood pressure, insulin resistance and a history of smoking.
"If [sexual dysfunction] is an overt problem that drives a man to go to the doctor, it should clue the doctor to take a look at some possible cardiovascular symptoms before anything major and life threatening arises," Turek said.
"The age of this group is interesting," said co-author Stephanie Hastings. "I think it will become more relevant as people continue live longer."
The researchers want to expand the study in future to see if the results are consistent with a larger group of participants and following up with medalist participants in three or so years to see if their results have changed or stayed stable.
Turek and Hastings are also curious about exploring the connection between sexual dysfunction and cardiovascular disease in women. Source:Joslin Diabetes Center, Boston
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