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Men with erectile dysfunction have increased risk for cardiovascular events
December 21, 2005Men with erectile dysfunction 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.
More than 10 million men in the United States are affected by erectile dysfunction (ED), with an estimated 100 million men affected worldwide, according to background information in the article. The risk of erectile dysfunction is related to many factors, including age, smoking, diabetes, heart disease, depression, and hypertension. Because cardiovascular disease and erectile dysfunction share etiologies as well as pathophysiology (endothelial dysfunction) and because of evidence that degree of erectile dysfunction correlates with severity of cardiovascular disease, it has been postulated that erectile dysfunction is a sentinel symptom in patients with cardiovascular disease.
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 ED and subsequent cardiovascular disease over the course of 7 years. The study included men aged 55 years or older who were randomized to the placebo group (n = 9,457) 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 randomized to placebo, 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 incident erectile dysfunction after 5 years. After adjustment, incident erectile dysfunction was associated with a 25 percent increased risk for subsequent cardiovascular events during study follow-up. For men with either incident or prevalent erectile dysfunction, the increased risk was 45 percent.
"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.
"The implications of this study are substantial. With the availability of effective pharmacotherapy, an increasing number of men are seeking care for erectile dysfunction. It is estimated that more than 600,000 men aged 40 to 69 years in the United States develop erectile dysfunction annually. Our data suggest that the older men in this group have about a 2-fold greater risk of cardiovascular disease than [younger] men without erectile dysfunction. With 70 percent to 89 percent of sudden cardiac deaths occurring in men and with many men not having regular physical examinations, this analysis suggests that the initial presentation of a man with erectile dysfunction should prompt the evaluating physician to screen for standard cardiovascular risk factors and, as appropriate, initiate cardioprotective interventions," they write.
"Our data provide the first evidence, to our knowledge, of a strong association between erectile dysfunction and subsequent development of clinical cardiovascular events. Acknowledging this association over a 5-year period and the high prevalence of vasculogenic/atherogenic etiologies in men of this age, the presenting symptom of erectile dysfunction should prompt an assessment of cardiovascular risk factors and vigorous interventions as appropriate. 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.
JAMA and Archives Journals
Of the 9,457 men randomized to placebo, 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 incident erectile dysfunction after 5 years. After adjustment, incident erectile dysfunction was associated with a 25 percent increased risk for subsequent cardiovascular events during study follow-up. For men with either incident or prevalent erectile dysfunction, the increased risk was 45 percent.
"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.
"The implications of this study are substantial. With the availability of effective pharmacotherapy, an increasing number of men are seeking care for erectile dysfunction. It is estimated that more than 600,000 men aged 40 to 69 years in the United States develop erectile dysfunction annually. Our data suggest that the older men in this group have about a 2-fold greater risk of cardiovascular disease than [younger] men without erectile dysfunction. With 70 percent to 89 percent of sudden cardiac deaths occurring in men and with many men not having regular physical examinations, this analysis suggests that the initial presentation of a man with erectile dysfunction should prompt the evaluating physician to screen for standard cardiovascular risk factors and, as appropriate, initiate cardioprotective interventions," they write.
"Our data provide the first evidence, to our knowledge, of a strong association between erectile dysfunction and subsequent development of clinical cardiovascular events. Acknowledging this association over a 5-year period and the high prevalence of vasculogenic/atherogenic etiologies in men of this age, the presenting symptom of erectile dysfunction should prompt an assessment of cardiovascular risk factors and vigorous interventions as appropriate. 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.
JAMA and Archives Journals
Erectile Dysfunction Current Events and Erectile Dysfunction News RSSDrug for erectile dysfunction improves heart function in young heart-disease patients
Heart function significantly improved in children and young adults with single-ventricle congenital heart disease who have had the Fontan operation following treatment with sildenafil, a drug used to treat erectile dysfunction and pulmonary hypertension, say researchers from The Children's Hospital of Philadelphia.
Pivotal study for PSD502 -- the first potential treatment for premature ejaculation
At the annual meeting of the Sexual Medicine Society of North America (SMSNA), Inc. in San Diego, Sciele Pharma, Inc., a Shionogi Company and Plethora Solutions Limited, a wholly owned subsidiary of Plethora Solutions Holdings PLC ("Plethora" - AIM:PLE)., today presented data from its second positive pivotal study of PSD502 for the treatment of premature ejaculation (PE).
Viagra for women? Drug developed as antidepressant effective in treating low libido
Pooled results from three separate clinical trials of flibanserin, a drug originally created as an antidepressant, show it is effective in treating women with acquired hypoactive sexual desire disorder. These trials were the first ever to test a therapy that works at the level of the brain to enhance libido in women reporting low sexual desire.
Workplace BPA exposure increases risk of male sexual dysfunction
High levels of workplace exposure to Bisphenol-A may increase the risk of reduced sexual function in men, according to a Kaiser Permanente study appearing in the journal Human Reproduction, published by Oxford Journals.
Study points to new uses, unexpected side effects of already-existing drugs
Scientists at the University of North Carolina at Chapel Hill School of Medicine and the University of California, San Francisco have developed and experimentally tested a technique to predict new target diseases for existing drugs.
Drug shows promise in treating dangerous complication of erectile disorder
Thousands of men are afflicted with an embarrassing and painful condition that triggers spontaneous, long-lasting erections. There are limited treatment options, but a solution could be on the way thanks to new research at The University of Texas Health Science Center at Houston.
BUSM researchers propose a relationship between androgen deficiency and cardiovascular disease
Researchers from Boston University School of Medicine (BUSM) in collaboration with researchers from Lahey Clinic Northshore, Peabody, Mass., believe that androgen deficiency might be the underlying cause for a variety of common clinical conditions, including diabetes, erectile dysfunction, metabolic syndrome and cardiovascular disease (CVD).
Diabetes weakens your bones
Current research suggests that the inflammatory molecule TNF-α may contribute to delayed bone fracture healing in diabetics.
Topical erectile dysfunction therapy shows promise
An innovative drug-delivery system - nanoparticles encapsulating nitric oxide or prescription drugs - shows promise for topical treatment of erectile dysfunction (ED), according to a new study by scientists at Albert Einstein College of Medicine of Yeshiva University.
Dr. Ronald Lewis Couples' treatment for sexual problems on the agenda for sexual medicine experts
Couples' treatment for sexual problems and other innovative approaches to improving sexual health for men and women are on the agenda of sexual medicine experts.
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