December 20, 2017
2 min read

Erectile dysfunction useful marker in CVD risk stratification

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Erectile dysfunction is linked to measures of subclinical CVD, according to data published in Vascular Medicine.

The results of the study further define the relationship between erectile dysfunction and CVD, suggesting erectile dysfunction may be a useful tool in the risk stratification of CVD, Chukwuemeka U. Osondu, MD, MPH, from the Center for Healthcare Advancement & Outcomes at Baptist Health South Florida in Miami and the department of epidemiology at the Robert Stempel College of Public Health and Social Work at Florida International University, and colleagues wrote.

“Delineating a consistent, strong association of [erectile dysfunction] with subclinical CVD will help in establishing [erectile dysfunction] as a simple and effective marker of underlying subclinical CVD,” Osondu and colleagues wrote.

Researchers used multiple databases to gather literature and studies exploring the link between erectile dysfunction and measures of subclinical CVD. Available results on the association of erectile dysfunction and measures of subclinical CVD were combined, including endothelial dysfunction measured by flow-mediated dilation, carotid intima-media thickness, coronary artery calcification and other measures of vascular function such as ankle-brachial index, toe-brachial index and pulse wave velocity, according to the study.

Osondu and colleagues found that erectile dysfunction was associated with a 2.64-percentage-point reduction in flow-mediated dilation vs. proper erectile function (95% CI, –3.12 to 2.15).

Patients with erectile dysfunction showed a 0.09-mm (95% CI, 0.06-0.12) increase of carotid intima-media thickness vs. those without erectile dysfunction.

A subgroup meta-analyses showed that mean study population age, erectile dysfunction assessment questionnaire or the publication date did not significantly affect the relationship between erectile dysfunction and carotid intima-media thickness or between erectile dysfunction and flow-mediated dilation.

“Future research should focus on determining the longitudinal relationship between [erectile dysfunction] and subclinical CVD and should involve larger sample sizes,” the researchers wrote. “As coronary artery calcification testing becomes more common, larger studies on its relationship with [erectile dysfunction] should also be conducted.”

In a related editorial, Matthew A. Kluge, MD, DO, and Naomi M. Hamburg, MD, MS, FACC, from the section of vascular biology at the Whitaker Cardiovascular Institute of Boston University School of Medicine, wrote the lack of prospective cohort studies makes it impossible to conclusively state that erectile dysfunction is preceded by vascular dysfunction.

They noted that the study, despite limitations, emphasized the relevance of erectile dysfunction to understanding the course of CVD.

“The presence of [erectile dysfunction] portends a higher risk of future cardiovascular events, particularly in intermediate-risk men, and may serve as an opportunity for intensification of cardiovascular risk prevention strategies,” they wrote. “The findings add to the growing evidence supporting additional trials to determine the clinical impact of [erectile dysfunction] screening and the appropriate cardiovascular-directed evaluation and treatment of men with [erectile dysfunction].” – by Dave Quaile

Disclosures: The authors, Hamburg and Kluge report no relevant financial disclosures.