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.
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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.
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Copyright
© 2009 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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- 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.
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