Impotence may serve as an early warning of Heart disease down the road, even in men without traditional risk factors for heart trouble, a new study suggests.

In a study of 143 middle-aged men, Italian researchers found that those with vascular erectile dysfunction (ED) were nearly four times as likely as those without the condition to show high levels of calcification in the heart arteries.

Calcium deposits, along with fat and other substances, are part of the artery-clogging “plaque” that accumulate in atherosclerosis, a “hardening” and narrowing of coronary arteries that can lead to Heart Attack and Stroke.

Computed tomography (CT), a specialized X-ray technique, can detect these calcium deposits, and it is sometimes used to screen for Heart disease before symptoms are apparent.

In the new study, CT scans revealed that arterial calcium deposits were more common and more extensive in men with ED - even though traditional heart risk factors, like High Blood Pressure and High cholesterol, were not.

“These data suggest that ED may be the earliest manifestation of a generalized vascular disease and that these patients may be at an increased risk of later developing coronary artery disease,” the study authors report in the Journal of the American College of Cardiology.

ED is known to involve impaired blood flow to the penis, and men with conditions in which blood circulation is impaired, such as atherosclerosis and diabetes, are at increased risk of sexual dysfunction.

But for some men, Impotence may be just the “tip of the iceberg” in regard to their cardiovascular health, said Dr. Emilio Chiurlia, the study’s lead author.

“In our study, we found an increased prevalence of subclinical Atherosclerosis among patients with ED, independently of traditional risk factors,” said Chiurlia, a researcher at the University of Modena and Reggio Emilia in Modena.

Given this, he added, traditional risk factors like high blood pressure, smoking and elevated cholesterol may not be enough to predict which men with ED are at particular risk of Heart disease.

Instead, it may be necessary to look for “novel markers,” such as calcium deposits in the arteries, according to Chiurlia. However, he said, more research is needed to determine that.

In the U.S., CT scanning for coronary calcification is available, but because it is a screening procedure for people without symptoms, most insurance plans do not cover it.

The current study included 70 men with ED and 73 men who did not have the condition but were similar to the ED group as far as age, smoking habits, blood pressure and other risk factors for cardiovascular disease.

Overall, men with ED were more than twice as likely as their peers to show calcium deposits in the coronary arteries. Moreover, 41 percent had a high calcium “score,” versus 19 percent of men in the comparison group.

ED patients also showed poorer blood vessel function in the arm’s brachial artery - another potential indicator of future Heart disease.

It’s possible, according to Chiurlia, that smaller blood vessels, including those that supply the penis, are more sensitive to early artery disease than are the larger vessels of the heart.

SOURCE: Journal of the American College of Cardiology, October 18, 2005.