The Inside Edge

Older men can lower their risk of developing erectile dysfunction (ED) by having regular intercourse, according to researchers in Finland. Their questionnaire-based study evaluated the effects of coital frequency on subsequent risk of ED among 989 men aged 55 to 75 years. The overall incidence of moderate or complete ED was 32 cases per 1,000 person-years. Men who reported having intercourse less than once a week at baseline had twice the incidence of ED at five years' follow-up compared with those reporting intercourse once a week. ED risk was inversely related to the frequency of intercourse. The researchers conclude that doctors should support patients' sexual activity.
Koskimaki J, Shiri R, Tammela T et al. Am J Med 2008; 121(7): 592-6

The cardioprotective effect of moderate alcohol consumption has been widely reported, but whether this is experienced equally by all moderate drinkers is questionable.UK researchers examined the association between average weekly alcohol intake and incidence of MI among 9,655 individuals without prevalent disease, over 17 years. A significant benefit of moderate drinking compared with abstinence or heavy drinking was found among those with poor health behaviour (little exercise, poor diet, smokers). No additional benefit from alcohol was found among those with the healthiest behaviour (three hours or more of vigorous exercise per week, daily fruit/vegetable consumption, non-smokers).
Britton A, Marmot MG, Shipley M. J Epidemiol Community Health 2008; 62: 905-8

Evidence suggests women who have hot flushes have adverse vascular changes, but it is unknown whether hot flushes are associated with subclinical cardiovascular disease (CVD). Researchers in the US measured indices of subclinical CVD (flow-mediated dilation, coronary artery and aortic calcification), estradiol concentration and number of hot flushes in the previous two weeks among 492 women aged 45 to 58 years. Participants had no clinical CVD, and had a uterus and at least one ovary. Hot flushes were found to be associated with significantly lower flow-mediated dilation and greater coronary artery (OR 1.48) and aortic calcification (OR 1.63).
Thurston RC, Sutton-Tyrrell K, Everson-Rose SA et al. Circulation 2008; 118: 1234-40

Men who have undergone bilateral nerve-sparing radical prostatectomy (NSRP) have more success with the PDE5 inhibitor vardenafil when using it on-demand, rather than as a nightly dosing regimen. Patients due to undergo NSRP were recruited to this international trial and randomised to receive placebo, nightly vardenafil, or on-demand vardenafil; 423 participants completed the study. On-demand use was associated with significantly greater erectile function and sexual intercourse completion rates compared with placebo. Furthermore, success rates among those using vardenafil on-demand were higher than for nightly use. The researchers argue that this supports a move to on-demand use in this group.
Montorsi F, Brock G, Lee J et al. Eur Urol 2008; 54(4): 924-31

Elevated levels of estrogens appear to be associated with an unfavourable lipid profile in men, even early in life, according to researchers at Leicester University. Associations between estradiol, estrone and their precursors (total testosterone and androstenedione), and traditional cardiovascular risk factors (lipids, BP, body mass) were investigated in 933 apparently healthy men aged a median 19 years. Estradiol was associated positively with total cholesterol and negatively with HDL; estrone showed strong positive associations with total cholesterol and LDL. Therefore, men with the highest concentrations of estrone and estradiol may have the highest cardiovascular risk. Why endogenous estrogens that are generally cardioprotective in women increase cardiovascular risk in men remains to be elucidated, the researchers add.
Tomaszewski M, Charchar FJ, Maric C et al. Atherosclerosis 2008; doi:10.1016/j.atherosclerosis. 2008.06.002

Email suggestions to MIMS Cardiovascular editor at paula.hensler@haymarket.com.

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