The Prevalence of Erectile Dysfunction and Its Association with Cardiovascular Risk Factors in Patients after Myocardial Infarction

Abstract

Background and Objectives: This study estimates the prevalence and severity of erectile dysfunction and its association with cardiovascular risk factors in patients after a myocardial infarction. Materials and Methods: This study included men aged 35–80 years, diagnosed with myocardial infarction and examined in the Department of Preventive Cardiology of Vilnius University Hospital Santaros Klinikos between 2016 and 2020. Anthropometric characteristics, blood pressure, lipid profile, blood glucose levels and prevalence of cardiovascular risk factors were evaluated. The International Index of Erectile Function-5 was used to assess patients’ erectile function. Results: A total of 171 patients were analysed. The mean age was 57.6 ± 8.8 years. Of the patients, 42.1, 25.1 and 11.7% had three, four and five established cardiovascular risk factors, respectively. Of the patients, 100% were diagnosed with dyslipidaemia, 90.0%—arterial hypertension, 14.6%—diabetes, 23.3%—smoking, 43.7%—positive familial history and 54.5%—insufficient physical activity. The overall prevalence of erectile dysfunction was 62%. It was scored mild in 37.4%, mild-to-moderate—15.2%, moderate—5.3% and severe in 4.1% of the patients. The mean age was significantly different between severity groups (p < 0.001). The study demonstrated a negative correlation between age and total score of the questionnaire (r = −0.308, p < 0.001). Arterial hypertension was more frequent in the patients with erectile dysfunction (p = 0.02). Other cardiovascular risk factors were distributed similarly. Conclusions: Erectile dysfunction is common in patients after a myocardial infarction and its severity is age dependent. The prevalence of cardiovascular risk factors is high, with arterial hypertension significantly more frequent in patients with erectile dysfunction.

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“…Once thought to be psychogenic in etiology, ED nowadays is associated mainly with vascular diseases [ 12 ]. Diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment are some of the more common conditions associated with ED.…”

“…Developing evidence suggests that the formation of atherosclerotic plaques in blood vessels, considered a major pathophysiological mechanism, which leads to the development of cardiovascular disease, is responsible for causing functional damage to the inner layer of the vascular wall, the endothelium [ 12 ].…”

“…When the endothelial integrity is impaired, its permeability is increased; thus, it activates platelets and leukocytes, resulting in the activation of various cytokines and reducing NO production. This leads to impaired vasodilation [ 12 ]. ED is considered an early marker of cardiovascular disease, additionally also associated with the increased possibility of cardiovascular disease.…”

Accurate and time‐saving, two‐step intracavernosal injection procedure to diagnose psychological erectile dysfunction

“…On the other hand, 50%-80% of all cases of organic ED are because of arterial insufficiency of the penile vessels and must be recognized, as the presence of ED could be considered a hallmark of future minor and major cardiovascular events. [13][14][15][16] Vascular ED and major cardiovascular events could be considered different manifestations of the same systemic arterial damage that, because of the small diameter of penile arteries, causes sexual dysfunction earlier than other events. 17 While a normal erectile function consists of an adequate arterial inflow and a poor or absent venous outflow, in the presence of impaired cavernosal smooth muscle relaxation or arterial inflow stenosis erection is impaired.…”

“…In this setting, the most frequent form is expected to be of psychogenic origin. On the other hand, 50%–80% of all cases of organic ED are because of arterial insufficiency of the penile vessels and must be recognized, as the presence of ED could be considered a hallmark of future minor and major cardiovascular events 13–16 . Vascular ED and major cardiovascular events could be considered different manifestations of the same systemic arterial damage that, because of the small diameter of penile arteries, causes sexual dysfunction earlier than other events 17 .…”