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In one Hong Kong-based study involving 2,306 men with type-2 diabetes, slightly more than one fourth of the subjects had erectile dysfunction at the start of the study, and none of the participants had any signs or history of heart disease, stroke or vascular disease. After four years, 123 of these men either experienced a heart attack, died from heart disease, developed chest pain caused by clogged arteries, or needed bypass surgery or a catheter procedure to restore blood flow to the heart. Men who had erectile dysfunction at the beginning of the study were much more likely to experience one of these coronary heart disease (CHD) events. A statistical analysis revealed that out of every 1,000 diabetic men with erectile dysfunction, 19.7 could be expected to experience a CHD event each year, as compared to only 9.5 of 1,000 diabetic men without erectile dysfunction. After a complete analysis of many other factors, the study concluded that erectile dysfunction is an early warning sign for heart disease and that it indicated a 58% increase in the risk for CHD. What Is the Penis? In the study, Li and colleagues examined 230 workers in four Chinese factories near Shanghai that either manufactured BPA or used BPA to manufacture epoxy resin. The men worked as packagers, technical supervisors, laboratory technicians and maintenance workers. What causes erectile dysfunction (ED)? buy Viagra 200mg here canadian pharmacy viagra