June 11, 2018
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Erectile dysfunction predicts risk for CV events

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Michael Blaha, MD, MPH
Michael J. Blaha

Men with erectile dysfunction had an increased risk for future CV events, according to a study published in Circulation.

“Our results reveal that erectile dysfunction is, in and of itself, a potent predictor of cardiovascular risk,” Michael J. Blaha, MD, MPH, associate professor of medicine at Johns Hopkins University School of Medicine and Cardiology Today Next Gen Innovator, said in a press release. “Our findings suggest that clinicians should perform further targeted screening in men with erectile dysfunction, regardless of other cardiac risk factors, and should consider managing any other risk factors — such as high blood pressure or cholesterol — that much more aggressively.”

S. M. Iftekhar Uddin, MBBS, MSPH, master’s student at Johns Hopkins Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University School of Medicine, and colleagues analyzed data from 1,914 men (mean age, 69 years) from the MESA cohort study who answered a question on erectile dysfunction symptoms.

Patients were followed up for 3.8 years for hard CHD and CVD events. Hard CHD events included resuscitated cardiac arrest, MI and CHD death. Hard CVD events were defined as all hard CHD events plus overall stroke and fatal stroke.

Men who reported erectile dysfunction symptoms accounted for 45.8% of the study population. These men were more likely to have diabetes, to have a family history of CHD and to use antihypertensive, beta-blocker, antidepressant and lipid-lowering medications than those who did not report symptoms.

During follow-up, 75 hard CVD and 40 hard CHD events occurred. Compared with those without erectile dysfunction, more men who reported the condition had hard CHD (3.4% vs. 1.4%; P < .001) and hard CVD events (6.3% vs. 2.6%; P < .001).

After adjustment, erectile dysfunction was a significant predictor of hard CVD events (HR = 1.9; 95% CI, 1.1-3.4). The association between erectile dysfunction and hard CHD events was not significant, although it had a similar point estimate of risk.

In a cross-sectional analysis, there was a significant association between prior CVD events and erectile dysfunction at visit five (OR = 2.1; 95% CI, 1.4-3.2). After adjusting for medication use and depression, the association remained significant, although it was weakened (OR = 1.7; 95% CI, 1.1-2.6).  

“Our findings strengthen the existing evidence for the independent association between [erectile dysfunction] and incident CVD, and could have important clinical implications for risk stratification in middle-aged men,” Uddin and colleagues wrote. – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.