( Health.com ) -- Middle-aged men who take steps to improve their heart health by eating better , getting more exercise , or taking cholesterol-lowering drugs may end up improving their sex lives as well , according to a new analysis of existing research . Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erection , a condition known as erectile dysfunction ( ED ) . The new study , which appears this week in the Archives of Internal Medicine , suggests that ED drugs such as Viagra are n't the only solution and are n't always enough to address the problem , says coauthor Dr. Stephen Kopecky , M.D. , a cardiologist at the Mayo Clinic in Rochester , Minnesota . `` If you do take care of your lifestyle—eating right , exercising , losing weight—you respond much better to the Viagra , the Levitra , the Cialis , '' Kopecky says . By the same token , he adds , if these drugs become less effective `` that should be a sign that ... you need to take care of your lifestyle . ' '' Health.com : 7 ways to treat erectile dysfunction . ED is troubling enough by itself , but to make matters worse it 's also a known harbinger of heart disease . The arteries in the penis that expand during an erection can become weakened and clogged with cholesterol in the same way as the arteries that surround the heart . This is why ED often shows up three to five years ahead of life-threatening cardiovascular problems such as heart attack or stroke , especially in younger men , Kopecky says . `` The common denominator is blood flow , '' he explains . `` If you look at a guy in his 40s who has erectile dysfunction and then you compare [ him ] to another guy in his 40s who does n't have erectile dysfunction , the guy with ED is about 50 times more likely to have heart disease . '' Despite this well-established link , there has been little research into whether addressing risk factors for heart disease ( such as unhealthy cholesterol numbers ) can also reverse ED . The studies that have been conducted have been relatively small and have looked at a single location , which means they may not apply to the population as a whole , Kopecky and his colleagues say . Health.com : 10 heart-healthy rules to live by . To clarify the effect of heart-healthy lifestyle changes on ED , the researchers combed through the medical literature for placebo-controlled clinical trials in which men with ED modified their lifestyles or began taking cholesterol-lowering statin medications . The analysis was funded entirely by the Mayo Clinic . In the end they focused on six studies that included a total of 740 men and were conducted in the U.S. , Italy , Nigeria , and Iran . In all of the studies , which ranged in length from two months to two years , heart healthy regimens and better cholesterol numbers were associated with modest but measurable improvements on a survey that rates erectile function on a scale from 5 to 25 . The average improvement in sexual function seen in the pooled studies was three points , one point shy of the threshold experts consider `` clinically important . '' For some men , especially those with more persistent cases of ED , a change of that magnitude would be negligible . For those with mild or occasional ED , however , it would translate into noticeable improvements in sexual function , the researchers say . Health.com : Erectile dysfunction ? Try losing weight . Dr. Kevin Billups , M.D. , an associate professor of urology at the University of Minnesota , in Minneapolis , says that the close relationship between heart health and sexual function `` has n't become the public health message that it should be . '' Doctors and other experts need to do a better of job of informing the public that a healthier heart often means better erections , adds Billups , who studies the link between heart health and erectile function but did not participate in the new research . `` That 's the first thing I talk about with all the guys that come in now , '' he says , referring to the ED patients he sees in his urology practice . `` 'Are you watching your diet ? What kind of exercise program are you on ? ' Just putting these men on the ED medications ... probably is n't enough to get optimal results . '' Health.com : The best foods for your heart . Even if they 're told that it may improve their ED , getting men to change their lifestyle and lose weight is no easy task , Kopecky says . He stresses , however , that even small and simple lifestyle changes—such as eating at least five servings of fruits and veggies daily—can make a big difference . But the `` real key '' is exercise , Kopecky says . Just 10 minutes of vigorous exercise three times a week `` does a whole lot to improve your heart function [ and ] blood vessel function , '' he says . Copyright Health Magazine 2011 .
Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erection . Erectile dysfunction is also a known harbinger of heart disease . Doctors should inform the public of this connection , researchers say . Exercise is key for heart health and blood vessel function .