Daniel
Currently, cardiovascular disease has become the leading cause affecting public health. It is often observed in clinical practice that the initial symptom in male patients with cardiovascular disease is unrelated to the disease and frequently presents as poor erectile function.
Many of these patients develop erectile dysfunction after being diagnosed with cardiovascular disease. Conversely, clinically, patients with erectile dysfunction are at a significantly higher risk of developing cardiovascular disease.
Erectile dysfunction in men often indicates the presence of conditions such as coronary heart disease, high blood pressure, diabetes, obesity, and physical inactivity. Why does erectile dysfunction often accompany patients with cardiovascular disease? Why do patients with erectile dysfunction frequently develop the cardiovascular disease? What necessary connections exist between these two conditions?
Although these two diseases may seem unrelated, they have a significant underlying connection.
Erectile dysfunction is a joint male sexual dysfunction characterized by the inability to sustain or achieve an erection of the penis for more than three months, resulting in an unsatisfactory sexual life. In the past, it was also referred to as impotence and was believed to have primarily psychological or organic causes. There are three types of erectile dysfunction – organic, psychogenic, and mixed, among which organic dysfunction correlates with cardiovascular disease. Consequently, examinations for male erectile dysfunction usually include cardiac and vascular function assessments.
Data shows that 64% of men with erectile dysfunction have one or more chronic diseases, such as cardiovascular disease. Among them, 52%, 64%, and 75% of patients with hypertension, diabetes, and coronary heart disease also experience erectile dysfunction. Additionally, 43% of smokers have erectile dysfunction.
A study conducted abroad with 154 male patients, all suffering from organic erectile dysfunction, aimed to identify the diseases present in these patients. The results revealed that approximately 44% had high blood pressure, 22% were diabetic, and a notably high proportion had hyperlipidemia. Furthermore, 85% of the individuals were overweight.
Erectile dysfunction indicates men’s overall health, particularly for chronic conditions like cardiovascular disease. Both conditions share not only the pathogenesis of endothelial dysfunction with afflictions such as hypertension, coronary heart disease, and diabetes but also common risk factors like smoking, excessive alcohol consumption, and obesity. Moreover, individuals with erectile dysfunction are more likely to have other diseases in addition to chronic conditions.
Previously, many people failed to recognize erectile dysfunction as a physical ailment. However, recent studies have conclusively established a strong connection between male erectile dysfunction and cardiovascular diseases, unveiling a shared pathogenesis. Age, disorders in lipid metabolism, smoking, and obesity are common risk factors that can lead to erectile dysfunction and cardiovascular disease.
Cardiovascular diseases such as hypertension, diabetes, and dyslipidemia ultimately impact the function of the vascular endothelium, resulting in endothelial dysfunction. The endothelium, a layer lining the inner surface of blood vessels, plays a crucial role in determining their flexibility. Impaired vascular endothelial function leads to reduced vasodilation, a significant cause of erectile dysfunction in men.
The blood vessel walls are intact, elastic, and easily contactable in individuals with well-functioning endothelium. However, if the endothelial function is compromised, the blood vessel walls become rough and thick and may develop plaque, ultimately affecting their ability to contract.
Normal blood vessels constrict and relax appropriately to maintain adequate blood supply to organs. However, if the boats are constantly constricted, blood flow becomes insufficient, leading to ischemia in critical organs. Ischemia in the heart causes myocardial ischemia, resulting in angina pectoris or a heart attack. Ischemia in the brain’s blood vessels can lead to a stroke or shock. Likewise, ischemia in the penis prevents a normal erection, leading to erectile dysfunction.
Therefore, the flexibility of blood vessels directly affects blood flow. Poor vessel flexibility is a visible manifestation of endothelial dysfunction. Consequently, endothelial dysfunction is a fundamental cause shared by cardiovascular disease and erectile dysfunction.
Why does erectile dysfunction typically occur earlier than cardiovascular disease in males?
This can be attributed to the physiological structure of the penis. The penis comprises cavernous tissue, consisting of countless tiny arteries that eventually form the cavernous sinuses. This structure allows for immediate engorgement and erection upon sexual stimulation, enabling a significant inflow of blood into the cavernous blood vessels and creating the conditions necessary for sexual intercourse. When sexual excitement subsides, the ischiocavernosus muscle relaxes and releases its compression, allowing for the return of blood. The diameter of the arteries in the cavernous body is very small, only measuring 1-2 mm. Compared to other arteries in the human body, the cavernous artery is the thinnest and most sensitive, making it susceptible to pathological changes due to various stimuli.
Arteries in other parts of the body are relatively thicker, meaning that even if they are diseased, it takes time before severe symptoms develop or vital organs are affected.
From this perspective, erectile dysfunction and cardiovascular disease are two different manifestations of the same underlying pathological change. However, these diseases tend to manifest earlier in the penis. Consequently, individuals with erectile dysfunction often have coexisting cardiovascular disease.
Therefore, erectile dysfunction serves as a harbinger of cardiovascular disease in men. If an issue arises, it must be taken seriously and treated promptly to prevent cardiovascular disease.
