Is erectile dysfunction a predictor of cardiovascular events or stroke? A prospective study using a validated questionnaire

Abstract

Erectile dysfunction (ED) is linked to various cardiovascular risk factors and may therefore serve as a predictor of cardiovascular events. To gain further insight into this relationship, we reviewed all data regarding hospital admission for cardial or cerebral vascular disease that occurred until 2008 in a cohort of men who underwent a health investigation in 2001. Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. In total, 2506 men with a negative history of cardial or cerebral vascular disease were analysed. During the 6.5-year followup, 58 cardiovascular events (2.3%) occurred. Men without ED (IIEF-5 422; n ¼ 1636) at baseline developed a cardiovascular event in 1.9% (n ¼ 32) as compared with 2.9% ( þ 52%; n ¼ 26) in those with ED (IIEF-5 p22; n ¼ 670). In contrast to age (hazard ratio (HR): 1.6; 1.2-1.8 for every decade), hypertension (HR: 1.88; 1.1-3.1) and diabetes (HR: 2.6; 1.2-5.8), ED was not an independent risk factor for a cardiovascular event. Although men with ED were at increased risk for future cardiovascular events, ED was not an age-independent predictor of cardiovascular events in our cohort.

Erectile Dysfunction and Risk of Cardiovascular Disease

“…Many epidemiologic studies (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) have investigated the link between ED and risk of CVD, and most found a positive association. However, the magnitudes of the association varied between studies.…”

“…The key exposure variable was the presence or absence of ED at baseline. In most studies, men without ED served as the reference group, although in 3 studies (12,18,20), men with minimal or mild ED served as the reference group. We included all these studies for meta-analysis and performed a sensitivity analysis that only included studies with a reference group defined as strictly non-ED men.…”

Analyse d’articles. Avec la collaboration de la Société francophone de médecine sexuelle (SFMS)

“…Le caractère prédictif d'ECV de la DE a été démontré dans différentes populations non diabétiques [2,3] ou diabétiques [4,5]. Concernant le PEPD, il avait été suggéré mais non démontré qu'il pourrait être utile dans le dépistage des patients à haut risque cardiovasculaire.…”

Erectile Dysfunction as a Complication of Heart Failure

“…On the other hand, higher rates of atherosclerosis and coronary artery plaque burden [9] have been reported in patients with ED, and many groups have postulated that ED may be one of the earliest signs of cardiovascular disease [10], although other recent studies have not demonstrated supporting evidence [11].…”