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Erectile dysfunction linked to coronary heart disease events
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The presence of erectile dysfunction predicted new onset of coronary heart disease events in men with type 2 diabetes without clinically overt cardiovascular disease, according to the findings from a new study.
Researchers from The Chinese University of Hong Kong, Prince of Wales Hospital, conducted a study to examine the predictive power of erectile dysfunction on CHD events in 2,306 men with type 2 diabetes. The mean age of participants was 54.2 years.
The incidence of CHD events was 19.7/1,000 person-years (95% CI, 14.3-25.2) in men with erectile dysfunction compared with men without erectile dysfunction (9.5/1,000 person-years; 95% CI, 7.4-11.7); 26.7% of participants had erectile dysfunction at baseline, according to the study.
After adjustment for covariates including age, duration of disease and use of antihypertensive agents and albuminuria, erectile dysfunction remained an independent predictor (HR=1.58; 95% CI, 1.08-2.30).
Men who developed CHD events were older, had a higher frequency of erectile dysfunction and microvascular complications, longer diabetes duration, higher blood pressure, total cholesterol, LDL and urinary albumin/creatinine ratio, but they had lower HDL and estimated glomerular filtration rates than men without CHD events, according to the study. – by Christen Haigh
J Am Coll Cardiol. 2008;51:2045-2050.
Erectile dysfunction and cardiovascular disease are very common in men with type 2 diabetes. Although erectile dysfunction can be caused by macrovascular disease, it is more likely to be caused by microvascular disease involving the corpora cavernosa and/or vasonervorum supplying these structures. It is thought that endothelial dysfunction precedes anatomical changes in these structures. The prospective study by Ma et al found that both erectile dysfunction and macroalbuminuria are independent risks for future development of CHD in men with type 2 diabetes. This is consistent with findings in cross-sectional studies. A companion article by Gazzaruso et al from Italy (Archives Internal Medicine. 2008;51:2040) reports that erectile dysfunction and microalbuminuria are independent risk factors for major adverse cardiac events in diabetic men with angiographically proven asymptomatic coronary artery disease. These studies underscore the risk of coronary heart disease and major adverse cardiac events in diabetic men with erectile dysfunction and albuminuria.
– Glenn R. Cunningham, MD
Endocrine Today Editorial Board member