Subclinical vascular disease linked to erectile dysfunction

CHICAGO — Men with subclinical vascular disease are more likely to develop erectile dysfunction than men with no evidence of subclinical vascular disease, researchers reported at the American Heart Association Scientific Sessions.

“This is the first study of its kind to predict future onset of self-reported erectile dysfunction using subclinical vascular disease measures,” David I. Feldman, BS, research assistant at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins, told Cardiology Today.

Feldman and colleagues analyzed 1,862 asymptomatic men (mean age, 63.9 years) from the Multi-Ethnic Study of Atherosclerosis who were not taking erectile dysfunction medications at baseline. All had erectile dysfunction assessment an average of 9.4 years after baseline.

David I. Feldman

The researchers assessed the relationship between two categories of baseline subclinical vascular disease and subsequent self-identification of erectile dysfunction: atherosclerosis, which was assess CAC, carotid intima-media thickness carotid plaque and ankle-brachial index, and vascular stiffness and dysfunction, which was assessed using carotid ultrasound, MRI of the aorta and flow-mediated dilation.

Forty-five percent of men self-reported erectile dysfunction at the assessment 9.4 years after baseline. The prevalence of erectile dysfunction was related to the number and severity of subclinical disease abnormalities. Of those with two subclinical vascular disease abnormalities, 67.2% had erectile dysfunction (adjusted OR=1.5; P<.05), compared with 50.1% of those who had one abnormality and 30.9% of those who had no abnormalities, Feldman and colleagues found.

Measures of atherosclerosis were more closely associated with erectile dysfunction than measures of vascular stiffness and dysfunction, according to the researchers.

In a fully-adjusted model, the only subclinical disease measures associated with development of erectile dysfunction were the presence of CAC (adjusted OR=1.5; 95% CI, 1.2-1.9) and CAC >100 Agatston units (adjusted OR=1.4; 95% CI, 1.1-1.9).

“Further research is needed before clinicians routinely adopt the [CAC] test over other noninvasive methods to predict [erectile dysfunction], but these results have important implications for a prevention and men’s health clinic,” Feldman said in an interview. “Men who are clearly at risk for future [erectile dysfunction] and CVD as shown by the presence of [CAC] should follow heart-healthy diets, focus on improved levels of physical activity and avoid smoking in order to improve long-term erectile function and to avoid worsening [CV] health.” – by Erik Swain

For more information:

Feldman DI. Abstract #12049. Presented at: American Heart Association Scientific Sessions; Nov. 15-19, 2014; Chicago.

Disclosure: Feldman reports no relevant financial disclosures.