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Heart Disease, Atherosclerosis, and High Blood Pressure. Heart disease, atherosclerosis, high blood pressure, and high cholesterol levels are major risk factors for erectile dysfunction. In fact, erectile problems may be a warning sign of these conditions in men at risk for atherosclerosis. Men who experience ED have a greater risk for angina, heart attack, or stroke.
The idea was that plaque buildup reduces blood flow in the penis, making an erection difficult. However, experts now believe that erectile dysfunction preceding heart problems is more often due to the dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle. Endothelial dysfunction causes inadequate blood supply to the heart and impaired blood flow to the penis, and aids in the development of atherosclerosis.