Peter Chun-Yip Tong of The Chinese University of Hong Kong, Prince of Wales Hospital, in Hong Kong says diabetes, erectile dysfunction and heart disease share an ominous link: damage to the blood vessels by high blood sugar levels.

The same process that hinders the extra blood flow needed to maintain an erection can have even more serious consequences in the heart, the researchers say.

"The development of erectile dysfunction should alert both patients and healthcare providers to the future risk of coronary heart disease," Tong says in a statement. "Other risk factors such as poor blood glucose control, high blood pressure, high cholesterol levels, smoking and obesity should be reviewed and addressed aggressively."

Researchers recruited 2,306 men with type 2 diabetes and tracked them for about four years. One-quarter had erectile dysfunction at the beginning of the study but none had signs of heart disease.

The study, scheduled to be published in the Journal of the American College of Cardiology

found erectile dysfunction signaled a 58 percent increase in the risk of coronary heart disease.