OBJECTIVE
To assess the association between erectile dysfunction (ED) and the long-term risk
of coronary artery disease (CAD) and the role of age as a modifier of this association.
PARTICIPANTS AND METHODS
From January 1, 1996, to December 31, 2005, we biennially screened a random sample
of 1402 community-dwelling men with regular sexual partners and without known CAD
for the presence of ED. Incidence densities of CAD were calculated after age stratification
and adjusted for potential confounders by time-dependent Cox proportional hazards
models.
RESULTS
The prevalence of ED was 2% for men aged 40 to 49 years, 6% for men aged 50 to 59
years, 17% for men aged 60 to 69 years, and 39% for men aged 70 years or older. The
CAD incidence densities per 1000 person-years for men without ED in each age group
were 0.94 (40-49 years), 5.09 (50-59 years), 10.72 (60-69 years), and 23.30 (≥70 years).
For men with ED, the incidence densities of CAD for each age group were 48.52 (40-49
years), 27.15 (50-59 years), 23.97 (60-69 years), and 29.63 (≥70 years).
CONCLUSION
ED and CAD may be differing manifestations of a common underlying vascular pathology.
When ED occurs in a younger man, it is associated with a marked increase in the risk
of future cardiac events, whereas in older men, ED appears to be of little prognostic
importance. Young men with ED may be ideal candidates for cardiovascular risk factor
screening and medical intervention.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Mayo Clinic ProceedingsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- The worldwide prevalence and epidemiology of erectile dysfunction.Int J Impot Res. 2000; 12: S6-S11
- Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study.J Urol. 1994; 151: 54-61
- Sexual function in men older than 50 years of age: results from the health professionals follow-up study.Ann Intern Med. 2003; 139: 161-168
- Diabetes and sexual dysfunction: results from the Olmsted County Study of Urinary Symptoms and Health Status Among Men.J Urol. 2007; 177: 1438-1442
- Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both.Urology. 2004; 64: 1196-1201
- Predictors and prevalence of erectile dysfunction in a racially diverse population.Arch Intern Med. 2006; 166: 207-212
- The relationship between lipid profile and erectile dysfunction.Int J Impot Res. 2005; 17: 523-526
- Association between smoking and erectile dysfunction: a population-based study.Am J Epidemiol. 2005; 161: 346-351
- Prevalence of metabolic syndrome and its association with erectile dysfunction among urologic patients: metabolic backgrounds of erectile dysfunction.Urology. 2007 Feb; 69 (Epub 2007 Jan 31.): 356-360
- Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke?.Eur Urol. 2005; 48: 512-518
- Erectile dysfunction and subsequent cardiovascular disease.JAMA. 2005; 294: 2996-3002
- Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials.Mayo Clin Proc. 2007; 82: 20-28
- Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis.Eur Heart J. 2006 Apr; 27 (Epub 2006 Jan 24.): 824-831
- Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer.J Clin Oncol. 2006; 24: 4448-4456
- Androgens and cardiovascular disease.Endocr Rev. 2003; 24: 313-340
- The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease.Am J Cardiol. 2005 Dec; 96 (Epub 2005 Nov 4.): 19M-23M
- Linking erectile dysfunction and coronary artery disease.Int J Impot Res. 2005; 17: S12-S18
- Impotence is not always psychogenic. Newer insights into hypothalamic-pituitary-gonadal dysfunction.JAMA. 1980; 243: 750-755
- Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease.Eur Heart J. 2006 Nov; 27 (Epub 2006 Oct 20.): 2640-2648
- The prevalence of prostatism: a population-based survey of urinary symptoms.J Urol. 1993; 150: 85-89
- Natural history of prostatism: factors associated with discordance between frequency and bother of urinary symptoms.Urology. 1993; 42: 663-671
- History of the Rochester Epidemiology Project.Mayo Clin Proc. 1996; 71: 266-274
- A brief male sexual function inventory for urology.Urology. 1995; 46: 697-706
- Assessment of male sexual function by the Brief Sexual Function Inventory.BJU Int. 2006; 97: 316-323
- Distribution of the Brief Male Sexual Inventory in community men.Int J Impot Res. 2003; 15: 185-191
- Trends in the incidence and survival of patients with hospitalized myocardial infarction, Olmsted County, Minnesota, 1979 to 1994.Ann Intern Med. 2002; 136: 341-348
- Coronary disease surveillance in Olmsted County objectives and methodology.J Clin Epidemiol. 2002; 55: 593-601
- Temporal trends in the incidence of coronary disease.Am J Med. 2004; 117: 228-233
- Validation of death certificate diagnosis of out-of-hospital coronary heart disease deaths in Olmsted County, Minnesota.Mayo Clin Proc. 2000; 75: 681-687
- Modeling Survival Data: Extending the Cox Model. Springer-Verlag, New York, NY2000
- The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine.J Sex Med. 2006; 3: 28-36
- Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts Male Aging Study.Prev Med. 2000; 30: 328-338
- Mechanical factors in arterial aging: a clinical perspective.J Am Coll Cardiol. 2007 Jul 3; 50 (Epub 2007 Jun 18.): 1-13
- A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men.Int J Impot Res. 2007 Mar-Apr; 19 (Epub 2006 Aug 17.): 218-225
- Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study.BJU Int. 2004; 94: 1310-1313
- Immediate improvement in penile hemodynamics after cessation of smoking: previous results.Urology. 2007; 69: 163-165
- Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial.JAMA. 2004; 291: 2978-2984
- Sexual dysfunction in hypertensive patients treated with losartan.Am J Med Sci. 2001; 321: 336-341
- Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study.J Urol. 2006; 176: 222-226
Article Info
Footnotes
Funding for this study was obtained from Merck Research Laboratories and the National Institutes of Health (DK58859, AR30582, HL59205, and RR24150). Dr Nehra is a consultant for Pfizer, GlaxoSmithKline, and sanofi-aventis.
Identification
Copyright
© 2009 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Erectile Dysfunction and the “Window of Curability”: A Harbinger of Cardiovascular EventsMayo Clinic ProceedingsVol. 84Issue 2
- PreviewIn their landmark 2005 report of more than 9400 men, Thompson et al1 posed the following questions: “With the high prevalence of erectile dysfunction in aging men, do pharmacologic, lifestyle, or behavioral interventions that are cardioprotective also reduce or delay onset of erectile dysfunction? Could erectile dysfunction serve as a surrogate measure of treatment efficacy in preventive interventions for cardiac disease?” Today, 4 years later, these questions remain unanswered.
- Full-Text
- Preview
