Men who are impotent have a higher risk of subsequent cardiovascular events such as heart attack, stroke, and angina, according to a study in the December 21 issue of JAMA.
"Our data provide the first evidence, to our knowledge, of a strong association between erectile dysfunction and subsequent development of clinical cardiovascular events," the researchers wrote.
Ian M. Thompson, M.D., of the University of Texas Health Science Center at San Antonio, and colleagues studied a group of men who were assessed for erectile dysfunction and subsequent cardiovascular disease over the course of 7 years.
More than 10 million men in the United States are affected by erectile dysfunction (ED), with an estimated 100 million men affected worldwide. The risk of impotence is related to many factors, including age, smoking, diabetes, heart disease, depression, and hypertension.
The study included men aged 55 years or older who were randomized to the placebo group in the Prostate Cancer Prevention Trial at 221 U.S. centers. Participants were evaluated every 3 months for cardiovascular disease and erectile dysfunction between 1994 and 2003.
In analysis, factors at study entry taken into account included age, body mass index, blood pressure, serum lipids, diabetes, family history of heart attack, race, smoking history, current use of antihypertensive medication, physical activity, and quality of life.
Of the 9,457 men using placebos, 8,063 (85 percent) had no cardiovascular disease at study entry; of these men, 3,816 (47 percent) had erectile dysfunction at study entry.
Among the 4,247 men without erectile dysfunction at study entry, 2,420 men (57 percent) reported incidents of erectile dysfunction after 5 years. After adjustment, erectile dysfunction was associated with a 25 percent increased risk for subsequent cardiovascular events during study follow-up.
"Our analysis of men in the placebo group of this study demonstrates the substantial association between incident as well as prevalent erectile dysfunction and subsequent cardiovascular disease, including angina, myocardial infarction, stroke, and transient ischemic attack," the authors write.
"While a full cardiovascular evaluation is not necessary in response to findings of erectile dysfunction in asymptomatic patients, such findings should prompt diligent observation of at-risk men and reinforces the need for intervention for cardiovascular risk factors," the researchers conclude.
