Erectile Dysfunction More Than Doubles Risk of Heart Attack in Older Men, Study Finds

Men with erectile dysfunction (ED) are at higher risk for cardiovascular events, even when other risk factors, like cholesterol levels, smoking, and high blood pressure are considered, scientists report.

ED and cardiovascular disease share many risk factors, including obesity, hypertension, smoking, metabolic syndrome, and diabetes. However, little was known about ED’s role as an independent predictor of cardiovascular disease events.

The paper, published last month in Circulation, was based on data from the Multi-Ethnic Study of Atherosclerosis (MESA) study. At their fifth MESA visit, 1,914 men answered a question about ED symptoms. Almost 46% of the men said they were “sometimes able” or “never able” to have erections and were classified as having ED.

Next, the researchers followed 1,757 men (average age 69) for an average of 3.8 years. (One hundred fifty-five men from the original group were excluded because they had a cardiovascular disease event before the MESA study’s fifth visit.)

During that time, there were 115 “hard events.” Forty were related to coronary heart disease (CHD) - heart attack, resuscitated cardiac arrest, and CHD death. The rest were cardiovascular disease CVD hard events – all CHD hard events plus stroke and stroke death.

CHD hard events were reported for 3.4% of the men with ED and 1.4% of men without ED.

CVD hard events occurred in 6.3% of men with ED and 2.6% of men without ED.

After adjusting for other factors, such as age, cholesterol, smoking status, diabetes, medications, and family history of coronary heart disease, ED was still a significant predictor of hard CVD events. (For hard CHD events, the relationship was nonsignificant.)

“Our results reveal that erectile dysfunction is, in and of itself, a potent predictor of cardiovascular risk,” study senior investigator Michael Blaha, MD, MPH commented in a press release.

“Our findings suggest that clinicians should perform further targeted screening in men with erectile dysfunction, regardless of other cardiac risk factors and should consider managing any other risk factors -- such as high blood pressure or cholesterol -- that much more aggressively.”

Dr. Blaha added, “The onset of ED should prompt men to seek comprehensive cardiovascular risk evaluation from a preventive cardiologist. It is incredible how many men avoid the doctor and ignore early signs of cardiovascular disease, but present for the first time with a chief complaint of ED. This is a wonderful opportunity to identify otherwise undetected high-risk cases.”

Resources

American College of Cardiology

Rubenfire, Melvyn, MD, FACC
“Erectile Dysfunction as Predictor of Future CVD Events”
(June 19, 2018)
http://www.acc.org/latest-in-cardiology/journal-scans/2018/06/19/11/43/erectile-dysfunction-as-an-independent-predictor

American Heart Association

“Erectile dysfunction means increased risk for heart disease, regardless of other risk factors”
(June 11, 2018)
https://newsroom.heart.org/news/erectile-dysfunction-means-increased-risk-for-heart-disease-regardless-of-other-risk-factors

Circulation

Iftekhar Uddin, S. M., et al.
“Erectile Dysfunction as an Independent Predictor of Future Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis”
(Abstract. Originally published: June 11, 2018)
http://circ.ahajournals.org/content/early/2018/06/04/CIRCULATIONAHA.118.033990

Renal and Urology News

Persaud, Natasha
“Erectile Dysfunction Strongly Predicts Cardiovascular Events”
(June 11, 2018)
https://www.renalandurologynews.com/erectile-dysfunction-ed/erectile-dysfunction-strongly-predicts-cardiovascular-events/article/772613/