Cardiovascular Events Independently Predicted by Erectile Dysfunction

Man Erectile Dysfunction Sitting on Bed
Man Erectile Dysfunction Sitting on Bed
Significantly more coronary heart and cardiovascular disease hard events occurred in individuals with erectile dysfunction vs those without.

Erectile dysfunction (ED) is an independent predictor of future cardiovascular disease (CVD) events, according to a study published in Circulation. The risk associated with ED and CVD events is most likely attributable to the common risk factors shared by the 2 conditions, including smoking, hypertension, obesity, and diabetes.

Researchers enrolled 1757 male patients (mean age, 69±9.2 years) from MESA (Multi-Ethnic Study of Atherosclerosis) who attended 5 study visits and were considered to have ED based on providing a positive answer to the Massachusetts Male Aging Study question on ED symptoms. All patients were free of CVD and coronary heart disease (CHD) events before enrollment. During the 3.8-year follow-up, the investigators assessed all hard CHD (CHD death, resuscitated cardiac arrest, and myocardial infarction) and CVD (all CHD event plus stroke and stroke death) events.

Approximately half (45.8%) of study participants reported ED symptoms. Diabetes and a CHD family history were more common among participants with ED than participants without ED. In addition, those with ED reported using antihypertensive, antidepressant, β-blocker, and lipid-lowering medications more frequently than individuals without ED.

During follow-up, significantly more CHD and CVD hard events occurred in the participants with ED vs participants without ED (CHD events: 3.4% vs 1.4%; P <.001; CVD events: 6.3% vs 2.6%; P <.001). The unadjusted Cox models showed that ED provided significant prognostic value for future hard CVD (hazard ratio, 2.6; 95% CI, 1.6-4.1) and CHD (hazard ratio, 2.5; 95% CI, 1.3-4.8) events. In the fully adjusted analysis, the predictive value of ED for future CVD events persisted (hazard ratio, 1.9; 95% CI, 1.1-3.4). However, no significant predictive value was found in the adjusted analysis of ED for hard CHD events.

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Limitations of the study included its relatively short follow-up duration and the reliance on a single questionnaire item for determining ED.

The findings from the analysis “strengthen the existing evidence for the independent association between ED and incident CVD and could have important clinical implications for risk stratification in middle-aged men,” the authors wrote.


Uddin SMI, Mirbolouk M, Dardari Z, et al. Erectile dysfunction as an independent predictor of future cardiovascular events: the Multi-Ethnic Study of Atherosclerosis [published online June 11, 2018]. Circulation. doi:10.1161/CIRCULATIONAHA.118.033990