Impotence is a strong predictor of heart attack and death among high-risk patients, German researchers have said.

德国研究人员称，在某些高危病人中，阳痿是心脏病和死亡的重要信号。

The study of 1,519 men who already had cardiovascular（心脏血管的） disease found those who were also impotent（无力的） had twice the risk of a heart attack or death as the rest.

The University of Saarland report, published in the journal Circulation, suggests men with impotence should be checked for cardiovascular disease.

Some experts want doctors to ask about impotence in over-40s health checks.

Impotence is linked to inadequate¹ blood flow in the penile（阴茎的） arteries²（动脉） .

These are much smaller than coronary arteries（冠状动脉） .

So for some men, a persistent³ failure to get an erection might be an early sign that his arteries are narrowing.

The study followed men from 13 countries who already had cardiovascular disease. It monitored whether they went on to have heart attacks or strokes.

The participants were also asked about their erectile dysfunction（勃起功能障碍） at the start, after two years and after five years.

Powerful predictor

As well as being twice as likely to die or have a heart attack, those with impotence were also 10% more likely to have a stroke and 20% more likely to be hospitalised for heart failure, after adjusting for factors like age and smoking.

Lead author Michael Böhm said men who take medication（药物治疗） to treat impotence should also be checked for cardiovascular disease, but this does not always happen.

"The medication works and the patient doesn't show up anymore," Mr Böhm said.

"These men are being treated for the erectile dysfunction, but not the underlying⁴ cardiovascular disease. A whole segment of men is being placed at risk."

The study confirms previous research that has linked impotence and cardiovascular disease. It has been welcomed by British experts.