Is aging-related ED and essential hypertension the same disorder just in different organs?

Erectile dysfunction (ED) is caused by the inability of the artery that supplies blood to the penis to expand and contract properly. A recent study of this mechanism has led to a new understanding of the important link between ED and the development of coronary artery disease, and to new strategies for prevention and treatment.

The study is described in an article published by the Journal of Men’s Health titled “Hypertension: The Link Between Erectile Dysfunction and Coronary Artery Disease.” Its authors, Jacob Rajfer, MD, UCLA School of Medicine, Los Angeles, CA, and Martin Miner, MD, Warren Alpert School of Medicine, Brown University, Providence, RI, propose that “hypertension negatively affects the flow of blood to both the heart muscle and the erectile tissue of the penis. In both organs it appears to be caused by age-related cell death within the smooth muscle that lines the walls of the blood vessels.”

In fact, the authors say that logic would dictate that “preprogrammed genetic events” affecting the penile vasculature also impacts the peripheral vasculature and gives credibility to the theory that aging-related ED and essential hypertension are probably the same disorder, just in two different tissues. They added that this would also explain why hypertension, a major cause of EnD (endothelial dysfunction) and atherosclerosis, consistently ranks as the primary disorder associated with ED. EnD is an imbalance between vasodilating and vasoconstricting substances produced by (or acting on) the endothelium – the inner lining of blood vessels.

Since hypertension is one of the major causes of EnD, they concluded that it would be logical that men with ED should be screened for hypertension, whereas before they would be screened for EnD or even cardiovascular disease (CAD). Furthermore, the development of strategies to delay or prevent the onset of aging-related smooth muscle apoptosis seem warranted.

Men’s Health editor-in-chief, Ajay Nehra, MD, said in a press statement that “this article further substantiates the correlation between cardiac disease, hypertension, and erectile dysfunction and provides healthcare providers with an insight into discussing the status of erectile function.” Nehra is also a urology professor at Rush University Medical Center, Chicago, IL.

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