If a man with type 2 diabetes also suffers from erectile dysfunction (ED), it strongly suggests that he could well have coronary artery disease that’s not causing any symptoms. Commenting on his team’s findings, Dr. Carmine Gazzaruso noted that routine screening for silent coronary artery disease (CAD) "is not justified among patients with uncomplicated diabetes since there is low probability of finding significant CAD."
In this situation, erectile dysfunction "may help in discriminating subjects to test for silent CAD," said Gazzaruso, from the Maugeri Foundation Hospital in Pavia, Italy.
A strong association between ED and obvious, symptomatic heart disease has been seen in several studies, but until now the prevalence of ED has never been studied among diabetic patients with silent CAD, the researchers note in their report in the American Heart Association’s journal Circulation.
They looked at 133 men with uncomplicated diabetes and silent CAD (which was discovered by testing) and 127 with diabetes but no silent CAD. The team found that 33.8 percent of the men with silent heart disease had ED, compared with 4.7 percent of those without CAD.
Several other factors were linked to silent CAD, but "ED appeared to be the most efficient predictor of silent CAD." Gazzaruso also said that he believes physicians should "always" ask their male patients with diabetes about ED. In this way the doctor may "not only find more patients to treat for ED with improvement of their quality of life, but also identify a higher proportion of diabetics with silent ischemia," he said.
The researcher said he also believes that exercise testing should be considered for people with ED before they begin drug treatment, to make sure they don’t have silent heart disease. Circulation 2004.
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