Erectile dysfunction (ED) can be an early indicator of coronary artery disease (CAD) as both share similar risk factors like high blood pressure, high cholesterol, diabetes, obesity, and smoking. ED occurs when CAD disrupts blood flow not only to the heart but also to the penis. Lifestyle changes like exercising regularly, following a healthy diet, losing weight, quitting smoking, and limiting alcohol can help treat ED caused by CAD. Medications like PDE5 inhibitors and supplements have also shown effectiveness for this condition.

1. ERECTILE DYSFUNCTION: SILENT MARKER OF CORONARY ARTERY
DISEASE
INTRODUCTION
Erectile dysfunction (ED) is a serious health problem these days which is prevalent in men. It is reported
that 1 in 10 adult men suffer from erectile dysfunction. It originates due to various reasons such as stress,
depression, hormonal deficiency, etc. Under severe conditions, erectile dysfunction causes many health
co-morbidities. In some cases, it has been seen that erectile dysfunction is one of the indicator of other
health consequences such as endothelial dysfunction.
Recent studies suggest that there is a very strong link between erectile dysfunction and coronary
artery disease (CAD). Due to this, doctors should look more closely at the overall health of erectile
deficient men to check if it is an outcome of some other disease.
LINK BETWEEN ERECTILE DYSFUNCTION AND CORONARY ARTERY DISEASE
It is known that the coronary artery disease is a heart disease in which the arteries that supply blood to
the heart muscles become hardened & narrowed. This causes the disturbance in blood flow in the entire
body. This occurs due to many causes such as the building-up of cholesterol or fat inside the inner walls
of the blood vessels known as atherosclerosis.
Erection mechanism of the penis involves the extra blood flow towards the muscles of the penis. When
CAD disrupts the ability of blood to flow freely, it also causes the disturbance in the blood flow
towards penis. As a result, erectile dysfunction originates. Thus, CAD is one of the causes of erectile
dysfunction. In turn, erectile dysfunction can be regarded as one of the symptoms of CAD.

2. RISK FACTORS OF ERECTILE DYSFUNCTION AND CAD
As it
has been told that erectile dysfunction & CAD share a common disease process, it should also be known
that they also share many risk factors. These involve:
 High blood pressure: When the blood pressure is high for an extended time, it can damage the lining of
the arteries and interfere with the blood flow. This causes both CAD and erectile dysfunction due to
disturbance in blood flow. It is also reported that certain high blood pressure medications such as thiazide
diuretics also cause erectile dysfunction.
 High blood cholesterol: low density lipoproteins (LDL) cholesterol can also damage the arteries. The
buildup of this cholesterol in the arteries can clog them and restrict the blood flow. This can contribute to
erectile dysfunction, as well as CAD.
 Diabetes: People with diabetes are at higher risk of heart disease. They’re also more likely to develop ED
than people without diabetes.
 Obesity: Excess body weight and fat can worsen the condition of CAD and erectile dysfunction due to
the condition of atherosclerosis.
 Depression: Depression has been linked to both ED and heart disease. According to a research study,
men with sexual dysfunction and severe symptoms of depression may have a higher risk of
cardiovascular events.
 Smoking: Smoking damages the arteries and increases the risk of atherosclerosis. Tobacco use has also
been linked to erectile dysfunction.
TREATMENT OPTIONS FOR ERECTILE DYSFUNCTION CAUSED BY HEART DISEASE

3. If any man has erectile dysfunction originated from coronary artery disease, then, he should opt for
following treatment plans. Some of them can trigger directly coronary artery disease to treat the whole
scenario and some can treat or prevent erectile dysfunction stopping the further prevalence of coronary
artery disease. These treatment plans are:
Lifestyle changes
Exercise is recommended as part of a healthy lifestyle and helps to manage chronic
diseases. Researchers recommended that daily aerobic exercise should be at least 30 minutes and that
men should burn, on average, a minimum of 300 to 500 kcal to achieve the benefits of exercise for
erectile dysfunction.
Dietary interventions to improve erectile dysfunction originated from coronary artery
disease involves eating a diet high in fruits and vegetables, limiting intake of refined sugars and
processed foods, consuming more whole grains, legumes, nuts and seeds, replacing butter with healthful
fats such as olive oil, decreasing sodium intake by using more herbs and spices and limiting red meat
consumption.
The suggested mechanisms by which weight loss, healthy diet and physical exercise can improve
erectile function include the improvement of endothelial dysfunction, insulin-resistance and low-grade
inflammatory state associated with diabetes and metabolic diseases – all of which are risk factors for ED.
The resulting improved inflammatory status may help contribute to reduce the burden of sexual
dysfunction in men.
 Stop smoking & drinking alcohol
Both the direct use of tobacco and second-hand exposure seem a consolidated
risk factor for ED. The moderate consumption of alcohol may exert a protective effect on ED in both the
general population and in diabetic men. When the alcohol intake becomes excess then, it causes revers e
effect on the body causing depressed mood and low libido increasing erectile dysfunction.
 Clinical implications

4. o Phosphodiesterase 5 (PDE5) inhibitors: They are very effective for the treatment of erectile
dysfunction in patients with CAD. Numerous studies have shown that this class of drugs is safe in
patients with stable CAD. Other drugs which can be beneficial include angiotensin and statins, etc.
o Androgens: Men who present with diminished libido and erectile dysfunction may be found to have
low serum testosterone levels. Hormone administration may benefit men with severe hypogonadism
and may be useful as adjunctive therapy when other treatments are unsuccessful by themselves.
Libido and an overall sense of well-being are likely to improve when serum testosterone levels are
restored to the reference range.
o Supplements: Beside medications, it has been seen that food supplements or herbal supplements
have been shown to improve the condition of erectile dysfunction in men. These involve Korean Red
Ginseng, L-Citruline/L-Arginine, Yohimbe, etc.
One such herbal supplement originated from fenugreek seed extract, Chemforce is an innovative
product rich in protodioscin, which plays significant role in maintaining and improving
testosterone levels, which further contributes in muscle mass building and safe sports
supplement. It’s a unique blend of highly powerful ingredients, Furosap® which is a patent
protected and clinically evaluated fenugreek seed extract and Alpha Yohimbine which is a known
aphrodisiac. Furosap® has been proven safe and effective for maintaining overall energy and
vitality in men.
Angioplasty:
Balloon angioplasty has been studied as treatment for erectile dysfunction in men with focal
atherosclerotic narrowing of the penile artery.

5. REFERENCES
 http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-
20045141?pg=1
 http://www.medscape.com/viewarticle/504834
 http://my.clevelandclinic.org/health/articles/heart-disease-and-erectile-dysfunction
 https://medlineplus.gov/coronaryarterydisease.html
 http://emedicine.medscape.com/article/444220-treatment#d9
 http://www.todaysdietitian.com/newarchives/040715p44.shtml
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291878/
 https://clinicaltrials.gov/ct2/show/NCT02702882