Erectile difficulties deserve a cardiovascular check, not just a sexual-health fix
Men with erectile dysfunction later developed about 40% more cardiovascular disease and 60% more heart attacks. Relative differences were larger in younger men. Erectile problems often appear before chest pain, so check blood pressure, glucose and lipids instead of masking the problem with self-purchased pills.
What it takes
In China, registration costs a few dozen renminbi, and blood-pressure, glucose and lipid checks about RMB 100–200. Allow a hospital visit and a few days for results.
What you may gain
A meta-analysis of 14 cohort studies followed 92,757 men for an average of 6.1 years. Compared with men without erectile dysfunction, risks were 44% higher for overall cardiovascular events (RR 1.44, 95% CI 1.27–1.63), 62% higher for myocardial infarction (RR 1.62, 1.34–1.96), 39% higher for cerebrovascular events (RR 1.39, 1.23–1.57), and 25% higher for all-cause death (RR 1.25, 1.12–1.39). Cardiovascular mortality was not clearly different (RR 1.19, 0.97–1.46). Relative risks were higher at younger ages and in men initially at intermediate cardiovascular risk than in high- or low-risk groups. Studies using questionnaires found a relative risk of 1.61 (1.38–1.86), versus 1.27 (1.18–1.37) in studies asking a single question.
Context & considerations
All 14 studies were observational, not randomized: the 44% excess is an association, not proof of causation. One or two isolated episodes are different from a problem persisting for three months or longer. Checks overlap with blood pressure and fasting glucose, plus lipids, smoking and waist circumference. Avoid online “male enhancement” supplements. Legitimate treatments are prescription medicines; their labeling contraindicates nitrates, including nitroglycerin, because combining them can sharply lower blood pressure. See lifestyle improvement. The benefit rating is medium: 44% compares groups, not deaths prevented by one check. It is not rated small because, unlike the detection-only evidence for visible blood in urine, hypertension, diabetes and lipid disorders found here have established treatments.
Research & references
Vlachopoulos CV, Terentes-Printzios DG, Ioakeimidis NK, Aznaouridis KA, Stefanadis CI (2013). Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circulation: Cardiovascular Quality and Outcomes, 6(1), 99-109. https://doi.org/10.1161/CIRCOUTCOMES.112.966903 ; DailyMed, the US National Library of Medicine drug-label database. VIAGRA (sildenafil citrate) tablet, CONTRAINDICATIONS. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=d905dc8d-917f-4ea3-a4ee-a1ecf6967d4e