Thursday, January 26, 2023

Congestive Heart Failure And Erectile Dysfunction

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Heart Failure Explained Clearly – Congestive Heart Failure (CHF)

Usually, occasional erectile problems are nothing to worry about. But if you experience regular difficulty getting or keeping an erection, its best to see a doctor so they can rule out any underlying problems. They can also recommend suitable treatments.

The important thing is to understand that you dont have to live with ED. There are multiple treatment options, from oral medications to injections, pumps, and prostheses. Some men even find that their problems resolve by themselves once they begin treatment, and they no longer have the stress and worry of ED weighing them down.

Although youre probably not looking forward to talking with a doctor, remember that ED is common and something that health professionals deal with all the time.

How To Know If U Have Erectile Dysfunction Congestive Heart Failure Erectile Dysfunction

I heard him say that he wants to kill his brother, I m afraid he This time, it is very likely that he will act alone.Although he is only acting alone, he is a puppet master.This puppet master can refine many puppets, and it would not be so pleasant to suddenly attack.Wang Lun said lightly.Soon they walked to the tent where the injured guard was resting, stood beside the tent, and Chen Xuan opened the curtain and walked in.There are also two guards guarding the tent.This is their original companion, and they already have feelings for their companion.Just when everyone heard the sound of leaving the camp, the two of them voluntarily stayed here to guard.Seeing Chen Xuan walk in, the two of them immediately stood up towards Quan in excitement.Brother Chen, you re back.Brother Chen, his face seemed very painful just now.

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Studies have proven that there’s a link between heart disease and erectile dysfunction . According to research, a man suffering from ED stands a higher risk of suffering from heart disease. For instance, 64% of men who have suffered a heart attack, and 57% of men that had bypass surgery have had ED at least at one point in their lives.

When listing heart disease factors such as smoking and coronary artery diseases in the family lineage, ED is also counted as one of the risk factors. If you’re suffering from a heart condition, the right treatment from medical centers in Suffolk County, NY, will also solve your erectile dysfunction. Understanding the connection between these two conditions is helpful in dealing with them.

Recommended Reading: How To Get Resting Heart Rate

Cardiac Risk Assessment And Safety Of Sexual Activity In Hf Patients

The Second Princeton Consensus provides guidelines for assessing risk for sexual activity in patients with a cardiac history. Patients are stratified into one of three groups. Low risk includes asymptomatic patients with less than three cardiac risk factors, mild stable angina, more than 6 weeks post-myocardial infarction, New York Heart Association class I HF or mild valvular disease. Intermediate risk includes asymptomatic patients with more than three cardiac risk factors, moderate stable angina, between 2 and 6 weeks post-myocardial infarction or NYHA class II HF. High risk includes unstable angina, uncontrolled hypertension, NYHA class III or IV HF, less than 2 weeks post-myocardial infarction or moderateâto-severe valvular dysfunction. If patients are low risk, then resuming sexual activity is recommended. If patients are high risk, then it is recommended that sexual activity be postponed until the patient is stabilized. If patients are intermediate risk, assessment with cardiac testing is recommended to allow restratification into either low or high risk.26

Its All About Prescribing More And More Medications

Coq 10 for Congestive Heart Failure

Just look at the most commonly prescribed ACE inhibitors and their side effects.

To which you can add this huge side effect:

In the study, 50% of patients taking drugs such as ACE inhibitors reported erectile dysfunction.

ED was highly related to age, systolic blood pressure, pulse pressure, smoking status, statin therapy and kidney function. The addition of a thiazide diuretic to an inhibitor of the reninangiotensin system significantly increased the prevalence of ED.

Also Check: How To Lower Your Heart Rate While Running

Testosterone Therapy And Cardiovascular Disease

Testosterone therapy should be reserved for patients who are symptomatic of testosterone deficiency and they have biochemical evidence of low testosterone . In men with borderline TT , a TTh trial may be envisaged. While adding a PDE5 inhibitor can be considered in men who have not improved with TTh, the usual clinical scenario is to add TTh in patients who have not responded to PDE5 inhibitors. Improvement is dependent on the testosterone levels with better results being obtained at lower levels of TT. Despite evidence of benefit in patients with pre-existing cardiovascular conditions , it should be emphasized that TTh is not a medication with cardiovascular indications.

After the initiation of TTh patients should be evaluated at 3 and 6 months, and annually thereafter to assess response to treatment and monitor adverse effects. Assessment should include physical examination with particular attention to the prostate. At these intervals testosterone levels should also be monitored, as well as PSA, haematocrit, and HDL.

Erectile Dysfunction Predicts Heart Disease

The researchers examined data extracted from the Multi-Ethnic Study of Atherosclerosis, which is an ethnically diverse, community-based, multisite prospective cohort study that encompassed 1,914 study participants aged 6078.

Overall, the study found that erectile dysfunction puts men at double the risk of cardiovascular problems such as heart attack, cardiac arrest, sudden cardiac death, or stroke.

This heightened risk was independent of other risk factors such as high cholesterol, smoking, and hypertension.

The scientists say that their study provides the most reliable evidence yet that erectile dysfunction is a stand-alone risk factor for heart disease.

More specifically, over the 4-year study period, 115 heart attacks, strokes, sudden cardiac arrests, and sudden cardiac deaths were recorded.

Before other risk factors were considered, the analysis revealed that more than 6 percent of the men with erectile dysfunction experienced these heart problems, whereas these forms of heart disease affected only 2.6 percent of the men who did not have sexual dysfunctions.

After additional risk factors were taken into account, the risk remained almost twice as high for men with erectile dysfunction.

Dr. Blaha comments on the findings, saying, Our results reveal that erectile dysfunction is, in and of itself, a potent predictor of cardiovascular risk.

This is a wonderful opportunity to identify otherwise undetected high-risk cases, says Dr. Blaha.

Read Also: What Should My Target Heart Rate Be

Pharmacological Treatment Of Heart Failure In Patients With Ed

Many cardiovascular drugs, such as BBs, angiotensin converting enzyme inihibitors/angiotensin receptors blockers , aldosterone antagonists and statins, have been shown to exert a significant impact upon the prognosis in HF patients . This clearly means that withdrawing any of them may be difficult. However, as discussed above, different drugs of the same class can exert slightly different effects on metabolic and vascular function. When using drugs potentially responsible for ED, like BB, clinicians should carefully choose the best molecule to administer for any single patient. As previously outlined, newly developed BB, such as nebivolol, should be preferred.

Regarding the use of aldosterone blocking agents, a negative effect of spironolactone on erectile function has been demonstrated , probably due to the affinity of spironolactone for progesteron receptors. Other drugs of the same class, e.g. eplerenone, which has higher specificity for aldosterone receptors, have been demonstrated to exert no negative effect on sexual function. The Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study , was a randomized controlled study evaluating 6 642 HF patients, which showed an equivalence of eplerenone to placebo with respect to the incidence of gynaecomastia and ED. Therefore, when aldosterone antagonism is needed, the new agent eplerenone should be preferred.

Is There A Link Between Heart Disease And Erectile Dysfunction

Diastolic Heart Failure Treatment Study

There is a strong correlation between erectile dysfunction and heart disease in general, and between erectile dysfunction and CHF in particular. In one study,³ 75% of CHF patients reported suffering from ED.

So, it can be difficult to distinguish whether ED is caused by heart disease, or if they simply share a common cause.

Often, heart diseases affect men psychologically as their condition increases their fear of endangering themselves by elevating their heart rate. A study published in the journal Heart and Lung reported that among patients suffering from heart disease:

“Approximately three quarters reported a marked decrease in sexual interest and in the frequency of sexual relations caused by illness, with one quarter having ceased all sexual activity.”

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Erectile Dysfunction And Heart Disease Are Connected

ED is a common phenomenon among men who have coronary heart disease, says Johns Hopkins cardiologist Michael J. Blaha, M.D., M.P.H., director of clinical research at the Ciccarone Center for the Prevention of Heart Disease.

Coronary heart disease occurs when plaque builds up in the arteries, reducing blood flow to the heart and impairing the functioning of blood vessels. Healthy blood flow is also necessary for erectile function. In addition, some medications to treat high blood pressure can contribute to ED.

How To Investigate And Manage A Patient With Cardiovascular Disease Or Without Known Cardiovascular Disease

Crucial to the understanding of the relationship between ED and CVD and the management of ED patients within the context of the CVD were the consecutive Princeton Consensus Recommendations . The reader is strongly encouraged to refer to the most recent, third Princeton Consensus. Key notions in the assessment and management of the patient with organic ED are that he should be considered at increased CVD risk until recommended checks suggest otherwise, and ED identifies increased CVD risk in the presence or absence of CVD symptoms or history.

Exercise ability: the risk of sexual activity

Investigation for both the erectile dysfunction patient with and without overt cardiovascular disease

A thorough history , assessment of ED severity and duration, and physical examination are mandatory first-line elements of investigation. A resting electrocardiogram, measurement of fasting plasma glucose, and estimation of glomerular filtration rate are desirable tests that may be used to further characterize cardiovascular status and risk and to identify men who require additional cardiologic workup. Owing to the accumulating evidence supporting the link with CVD, the measurement of testosterone is recommended in all men with a diagnosis of organic ED, especially in those for whom phosphodiesterase type 5 inhibitor therapy failed.

Additional investigation for the erectile dysfunction patient without overt cardiovascular disease

Read Also: Target Heart Rate When Working Out

Potential Additional Treatments For Hf And Ed

Finally, despite cardiac transplantation and implantation of left ventricular assistance devices has improved survival and overall QoL in patients with terminal heart failure, their effects on sexual activity is not clearly defined, depending probably by the individual emotional response to such invasive therapies . Nevertheless, in these patients physical activity is usually encouraged and, as a consequence, sexual activity is not contraindicated.

Testosterone Deficiency And Cardiovascular Disease

Congestive Heart Failure

A component of the increased risk conferred by ED could be testosterone deficiency. Low testosterone leads to increased levels of total and LDL cholesterol, as well as to increased production of pro-inflammatory markers and mediators. Endothelial dysfunction and increased arterial wall thickness, stiffening, and calcification also ensue. On this basis it has been hypothesized that chronically lowered testosterone may increase CVD risk. Indeed, androgen deficiency has emerged as a predictor of CV events, as well as of all-cause and CV mortality, both in the general population and in patients with CV risk factors, with hypertension, with established CVD, and with ED. Viewed from the opposite angle, higher serum testosterone showed a protective role for CV events in elderly men. A 2010 meta-analysis limited to studies in middle-aged men found no association between total testosterone levels and CVD risk. However, a more recent meta-analysis involving a larger number of studies identified significant associations between androgen deficiency and increased risk of CVD and CVD mortality. It should be stressed, however, that the nature of these studies cannot prove causality. The possibility that low testosterone may be an epiphenomenon, marking poor general health rather than modulating CVD risk per se has to be explored.

Also Check: How To Avoid Heart Disease

Cardiac Drugs And Erectile Dysfunction

Many cardiac drugs may be implicated in the development of ED. A major role has been suggested for thiazide diuretics, beta blockers and lipid-lowering drugs.

Thiazide diuretics

Thiazide diuretics are commonly used to unload HF patients, in association with loop diuretics, especially when the latter do not achieve the desired diuretic effect. These drugs are also often prescribed among hypertensive patients, especially after the JNC VII, which indicated them as the first line therapy for uncomplicated hypertension . However, they have been associated to ED in a number of studies. In the Treatment of Mild Hypertension Study a higher incidence of ED has been reported at 2 years in patients treated with chlorthalidone compared with the placebo group. These results probably depend on the vascular and metabolic abnormalities caused by these drugs, including endothelial dysfunction and increased vascular oxidative stress , hyperlipidemia , insulin resistance , new onset diabetes mellitus , and stimulation of the sympathetic and reninâangiotensinâaldosterone systems Burnier & Brunner . In the ALLHAT study a higher incidence of type 2 diabetes was observed in the thiazide-treated group compared with the other treatment groups .

Beta blockers

Lipid-lowering drugs

Phosphodiesterase Type 5 Inhibitors: Effects On The Cardiovascular System

Regarding the follow-up of patients, after the initiation of therapy visits are recommended at 2- to 4-week intervals initially and less frequently thereafter in order to assess response to the treatment , consider dosage titration, monitor adverse effects, and assess overall health and psychosocial functioning.

Also Check: Can Dehydration Cause Low Heart Rate

Its Important To Connect The Dots

ED can be embarrassing. Many men dont mention it, even to their doctor. On the other hand, men who do see the doctor can be so focused on their distress in the bedroom that they fail to mention other worrying symptoms, says Blaha. Too many men ignore heart disease symptoms such as shortness of breath or chest pain. If you have ED, talk to your doctor about being screened for risk factors such as high blood pressure, diabetes and heart disease, especially if youve noticed other symptoms.

Pharmacological Treatment Of Erectile Dysfunction In Patients With Hf

ACE inhibitor induced cough

It has been estimated that over 300 millions of people worldwide will use sildenafil or other phosphodiesterases inhibitors by 2025 , most of them having cardiovascular co-morbidities. PDE5is have been demonstrated to be safe in men with CVD. Risk profile is similar in patients with and without CAD and sildenafil has been shown to be safe even in patients with multi-antihypertensive drug regimens regardless of the classes, although some precautions should be taken in order to minimize drugs-interaction risks . The main contraindication to PDE5is is the contemporary use of nitrates that can lead to severe hypotension as a consequence of excessive cGMP accumulation and vasodilation. For this reason guidelines recommend a 24-h time interval between the administration of any NO donor and sildenafil for tadalafil and vardenafil interval should be equal to 48 h. Sildenafil should also be used with caution and started at the lowest dose in patients taking α-blockers to avoid symptomatic hypotension. Similar care should also be taken for mixed α/β-blockers, such as carvedilol and labetalol.

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Distinction Between Organic And Psychogenic Erectile Dysfunction

Erectile dysfunction is defined as the inability to attain or maintain a penile erection sufficient for satisfactory sexual performance. Cases of ED may be classified as predominantly organic in nature, predominantly psychogenic, or mixed. Usual organic aetiologies are vasculogenic, hormonal, and neurogenic. Owing to the relationship of vasculogenic ED with CVD, it is important to distinguish men with predominantly vasculogenic ED from those with predominantly psychogenic ED or non-vasculogenic organic ED.

Table offers elements for distinction between organic and psychogenic disease. Of note is that in cases of organic origin, a psychogenic component may co-exist. The most common organic aetiology of ED is vasculogenic ., Co-existence of vascular disease, advancing age, and the presence of CVD risk factors and metabolic disorders increase the likelihood that ED is of vasculogenic aetiology.

The aetiology of predominantly psychogenic ED is multifactorial, and components may include psychiatric disorders , interpersonal problems with the sexual partner or misconceptions about normal sexual activity. Identifying and getting treatment for those patients with psychogenic causes of ED such as depression that may also increase CVD risk is also important.

Congestive Heart Failure Erectile Dysfunction

Suddenly, the Liaoyuan Sword in Chen Xuan s hand had displayed two consecutive sword qi, and I saw that Chen Xuan s hands constantly condensed a terrifying aura, and instantly attacked the monster.Under the continuous fighting, this monster was actually a little scared, and he didn t know what the monster was afraid of.Just as the monster was about to retreat, Chen Xuan suddenly discovered that the ground was actually saline alkali land.Seeming to know the weakness of this monster, Chen Xuan hurriedly grabbed a handful of soil from the ground, and then threw it towards the monster.The monster obviously didn t expect Chen high blood pressure and erectile dysfunction treatment Xuan to deal with him like this.In fact, this is because the monster s IQ is not online.He thought that the humans in the saline alkali land that he was afraid of would also be afraid.

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The Association Of Erectile Dysfunction And Cardiovascular Disease: A Systematic Critical Review

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  • Sue C. Jacobs and more…Handbook of Counseling Women
  • Encyclopedia of Lifestyle Medicine & Health2012
  • Encyclopedia of Lifestyle Medicine & Health2012
  • Psychobiological Processes in Health and Illness2011
  • Physical Healthcare and Promotion in Mental Health Nursing2015
  • Encyclopedia of Health and Behavior2004

So Why Isnt Your Doctor Suggesting You Try Taurine

Clinical Cardiology

Probably because your doctor hears the unrelenting sales pitches of Big Pharma.

Because he or she learned all about these ace inhibitors and medical school.

But they did not learn much at all about taurine, anything nutritional, or any supplement of any kind.

You may want to take your health into your own hands for the good of yourself and your body.

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