Erectile dysfunction: A teachable moment in the pharmacy

June 15, 2013

As you fill the Rx for that "little blue pill," use the opportunity to tell patients that ED can be a precursor of heart disease

DISPENSED AS WRITTEN

Most men think they know what to look for when it comes to heart disease. There are well-publicized signals such as angina (chest pain), high cholesterol, and blood pressure. But they frequently do not realize that erectile dysfunction (ED) is an equally accurate and important signal of heart disease.

In fact, it is one that is often overlooked. That’s why a pharmacist can make filling a prescription for Viagra or other popular ED drugs into a “teachable moment.” That’s worth thinking about during National Men’s Health Month.

The facts

In the Massachusetts Male Aging Study, men with ED had a 43% higher risk of dying from heart disease than men who had no such symptoms.

A 2010 study published in the Journal of the American Heart Association found that men with ED were 1.6 times more likely to suffer from a serious cardiovascular event such as a heart attack or stroke.

And my own years of experience as a cardiologist confirm that when men have ED, the problem often can be traced to reduced blood flow, the result of cardiovascular problems. Because the arteries feeding blood to the penis are smaller than those supplying blood to the heart, they can become restricted or blocked sooner than other vessels.

Canary in the coal mine

Despite a growing body of evidence supporting the finding that ED is the “canary in the coal mine” for heart disease, many men remain unaware of these larger implications of ED.

A quick, easy cure for ED is far more tempting than a visit to their primary care physician, urologist, or cardiologist, but popping that pill means they may miss the chance to uncover the vascular disease that is the underlying cause of their problem. Drugs for ED will work fine for the immediate problem, but they don’t protect against the risk of heart disease or stroke.

The link between ED and heart disease is especially important because it offers healthcare providers a chance to identify and treat problems well before they become a serious threat.

Because ED typically shows up two to three years in advance of more conventional symptoms - and up to five years before a heart attack - it offers men a window of time in which to take action to prevent further damage and even reverse damage already done.

The pharmacist’s role

That’s where the pharmacist comes in. While you’re filling that prescription for the “little blue pill,” you can remind the patient to tell his family physician, urologist, or cardiologist about his ED. Getting patients to address the possible underlying heart or vascular disease may even help them find a permanent, drug-free solution to ED.

As anyone in the medical profession knows, men often think they are indestructible. But pharmacists are in a unique position to help educate them. Ironically, the younger patients are when they experience ED, the greater the likelihood that it is caused by heart disease.

By encouraging your younger patients - those who are suffering from ED in their 40s, 50s, and 60s - to get checked out thoroughly, you could be helping them add many healthy years to their lives.

Dr. Joel Sklar is a board-certified cardiologist and chief medical officer at Marin General Hospital, Marin County, Calif.