Saturday, January 9, 2010

I Wonder: Are ED Prescribers Perhaps Missing This?

I Wonder: Are ED Prescribers Perhaps Missing This?

The abstract from a 2008 Journal of Nuclear Cardiology paper indicates that ED may be an indicator of something more serious:
The conditions that predispose patients to erectile dysfunction are substantially similar to the coronary artery disease risk factors, including diabetes mellitus, hypertension, hyperlipidemia, obesity, sedentary lifestyle, depression, age, and smoking. Because of these shared risks and overlapping pathophysiologic mechanisms, we designed this pilot study to address the hypothesis that the presence of coronary artery calcium, a known indicator of increased cardiac risk, is associated with erectile dysfunction.

Methods and Results. A prospective registry enrolled 9150 men who underwent multidetector computed tomography. Subjects supplied baseline data regarding demographic variables, coronary risk factors, and erectile dysfunction symptoms or lack thereof. The 2 groups then underwent computed tomography to screen for the presence or absence of coronary artery calcium. Subjects with erectile dysfunction were older, had higher triglyceride levels, had higher blood pressures, and were more likely to have measurable coronary artery calcification than men without erectile dysfunction (79% vs 58%,P<.001).

Conclusion. Erectile dysfunction is significantly associated with abnormal coronary artery calcification and, like peripheral arterial disease, might warrant consideration as a coronary artery disease risk equivalent.
The article itself is behind a paywall, but I presume that having taken demographic data on their sample into account, the significance indicates that it wasn't just because those suffering ED are older, more likely to have diabetes, etc., but that it is an indicator of likely coronary artery calcification. It does make me wonder: are men getting Viagra or Cialis prescriptions when perhaps someone should be doing the coronary artery calcification scan?

UPDATE: A reader pointed out that because these are prescription medications, you have to talk to a doctor to get them, who presumably checks for this sort of risk. Of course, all these spam emails I get offering these drugs "cheap" aren't requiring anyone to see a doctor. This is one of the arguments against a completely free market in prescription medications. I'm aware that there is an argument that if consumers didn't have to go to a doctor to get a prescription for antibiotics and other medicines, they would be cheaper--but there's the risks involved as well, such as the one I point out above, and breeding antibiotic resistant strains.

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