Erectile dysfunction as an independent predictor of future cardiovascular events

Abstract

Vascular erectile dysfunction (ED) and cardiovascular disease (CVD) share common risk factors including obesity, hypertension, metabolic syndrome, diabetes mellitus, and smoking. ED and CVD also have common underlying pathological mechanisms, including endothelial dysfunction, inflammation, and atherosclerosis.1 Despite these close relationships, the evidence documenting ED as an independent predictor of future CVD events is limited.

We therefore leveraged the MESA study (Multi-Ethnic Study of Atherosclerosis), an ethnically diverse, community-based, multisite prospective cohort study, to examine the value of self-reported ED for predicting incident coronary heart disease (CHD) and CVD in those free of these CVD events at baseline. Details of MESA have been described previously.2 Male MESA participants who attended visit 5 and answered the single Massachusetts Male Aging Study question3 on ED symptoms were considered for our analysis (n=1914). A participant was considered to have ED if he responded "never able" or "sometimes able" to the Massachusetts Male Aging Study question. After excluding 155 participants with a CVD event before visit 5, 1757 participants were followed for 3.8 years (interquartile range, 3.5-4.2) and outcomes of hard CHD and CVD events were assessed. Hard CVD events included all hard CHD events (myocardial infarction, resuscitated cardiac arrest, and CHD death), plus stroke and stroke death. Participants provided informed consent, and each study site obtained approval from their institutional review board.