Erectile dysfunction (ED) is not independently associated with atrial fibrillation, according to researchers from Taiwan.
Atrial fibrillation, an irregular heartbeat, can increase a patient’s risk for stroke, heart failure, heart attack, dementia, and chronic kidney disease. ED can be an early sign of cardiovascular disease. However, the connection between the two conditions has not been widely studied.
The researchers looked at retrospective data from the National Health Insurance Research Database, developed by Taiwan’s largest health insurer. They identified 6,273 men who had been diagnosed with ED from 2001 to 2009. A control group of 283,066 men without ED was also selected. The average age of all participants was 40 years.
The men were followed for a mean of 8 years. The men with ED tended to be older and have more comorbidities, such as hypertension, diabetes, dyslipidemia, and coronary artery disease.
Overall, 1.3% of the men with ED developed atrial fibrillation during the follow-up period. Similarly, 1.3% of the men without ED developed the condition. Risk was higher in men over age 55. Incidence and prevalence of atrial fibrillation increased as the men got older.
The research team also conducted a propensity-score matched analysis involving 3,516 men from each group. The men with ED were further divided into three subgroups based on the causes of their ED. Eighty-six percent had ED of organic origins. About 10% had psychosexual dysfunction. For 4%, ED was influenced by both organic and psychosexual factors.
Rates of atrial fibrillation were higher, although not statistically different, among the men whose ED had organic origins (1.3%, compared to 0.6% for men with psychosexual dysfunction and 0.7% for men with both organic and psychosexual considerations).
The authors noted that ED and atrial fibrillation have several common risk factors, including aging, hypertension, diabetes, obesity, and smoking. These similarities could explain why men who had ED with organic origins had higher rates of atrial fibrillation.
The researchers also pointed out that while ED is often caused by endothelial dysfunction, atrial fibrillation needs “structural remodeling.” This difference might explain why the two conditions were not associated.
“It takes time for cardiac atria to become larger and more fibrotic, to eventually become the perfect substrate for [atrial fibrillation],” the authors wrote.
They added that while ED is not independently associated with atrial fibrillation, it can still signal cardiovascular problems and “provide an opportunity for early diagnosis and disease progression.”
The study was published last month in The Journal of Sexual Medicine.
The Journal of Sexual Medicine
Liu, Kuan-Liang MD, et al.
“Erectile Dysfunction Is Not a Predictor of Atrial Fibrillation: A Population-Based Propensity-Score Matched Cohort Study”