Archive for October 18th, 2011

Lifestyle improvements and heart disease treatment may be better than drugs for ED

The results of a review published online on September 12, 2011 in the Archives of Internal Medicine reveal that engaging in beneficial lifestyle practices and obtaining treatment for cardiovascular disease risk factors significantly improve erectile dysfunction(ED) in middle aged men.  The meta-analysis is the first, to the author’s knowledge, to evaluate the effect of lifestyle interventions and cardiovascular risk factor reductions on the condition.

Researchers at the Mayo Clinic in Rochester, Minnesota selected six randomized clinical trials that included a total of 740 men with an average age of 55.4 years for their analysis.  The trials evaluated the effects of exercise and lifestyle change, a Mediterranean diet, an interval exercise program, weight loss and treatment with the drug atorvastatin on cardiovascular risk factors.  Erectile dysfunction was evaluated via questionnaire responses. 

The analysis affirmed that improvements in cardiovascular risk factors were associated with a reduction in erectile dysfunction.  Separate analyses of lifestyle and drug treatment were also both associated with a significant benefit.   

“Therapies currently used for the treatment of ED include oral therapy with phosphodiesterase type 5 (PDE-5) inhibitors, which are highly effective in the treatment of ED,” the authors write.  “However, we demonstrate that cardiovascular risk factor reduction improves ED even in men who are not responsive to PDE-5 inhibitors.”

“Our findings suggest that cardiovascular risk factor reduction provides incremental benefits in ED well beyond that achieved with the use of PDE-5 inhibitors,” they add.  “Adoption of lifestyle modifications and cardiovascular risk factor reduction will provide incremental benefit regardless of PDE-5 inhibitor use.”

Study finds good diet overcomes bad genes

In an article published online on October 11, 2011 in the journal PLoS Medicine, Dr Jamie Engert at McGill University in Montreal and his associates report that the risk conferred by a gene variant known to be a strong marker for cardiovascular disease is minimized by consuming a diet rich in fruit and vegetables. “We know that 9p21 genetic variants increase the risk of heart disease for those that carry it,” explained Dr Engert, of the Research Institute of the McGill University Health Centre. “But it was a surprise to find that a healthy diet could significantly weaken its effect.”

The researchers genotyped four variants in the 9p21 chromosome region of 8,114 participants in the INTERHEART study, a case-control study of men and women of varying ethnic backgrounds that compared those who had had an acute non-fatal heart attack to similar subjects without heart disease. Additionally, 9p 21 variants were analyzed in 19,129 participants in the FINRISK study, of whom 1,014 had cardiovascular disease. Dietary questionnaires ascertained the frequency of intake of vegetables, fruits and other foods.

Subjects whose intake of vegetables and fruit was low had the greatest risk of cardiovascular disease in association with a 9p21 variant compared to those whose intake was high. Among INTERHEART participants who consumed a diet rich in fruit and raw vegetables, the risk of heart attack was similar between carriers and non-carriers of a specific single nucleotide polymorphism in the 9p21 region. In the FINRISK study, having a high risk genotype was associated with a greater risk of cardiovascular disease among those with low or average intake of fruit, vegetables and berries, yet among those whose intake of these foods was high, the variant appeared to have no effect.

“We observed that the effect of a high-risk genotype can be mitigated by consuming a diet high in fruits and vegetables,” commented coauthor Sonia Anand, who is a professor of medicine and epidemiology at the Michael G. DeGroote School of Medicine at McMaster University. “Our results support the public health recommendation to consume more than five servings of fruits or vegetables as a way to promote good health.”

“Our research suggests there may be an important interplay between genes and diet in cardiovascular disease,” stated lead author Dr Ron Do, who is currently affiliated with Massachusetts General Hospital. “Future research is necessary to understand the mechanism of this interaction, which will shed light on the underlying metabolic processes that the 9p 21 gene is involved in.”