Male erectile dysfunction and cardiovascular disease: is there an intimate nexus?
BACKGROUND
Various studies report increased risk of erectile dysfunction (ED) in men with cardiovascular (CV) disease and postulate an intimate nexus between the two conditions.


OBJECTIVE
To examine the association of ED with CV risk factors and disease in a population-based cross-sectional observational study conducted in Western Australia (WA). Method. Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the WA Electoral Roll.


METHODS
In addition to items covering sociodemographic and self-reported clinical information, the 5-item International Index of Erectile Function (IIEF-5) was used.


RESULTS
Of the 1,580 participants, the ages of 1,514 were known and ranged from 20 to 99 years (mean 57.9, median 59.1, standard deviation 18.5). CV risk factors and disease were more prevalent with increasing age and among participants with ED and severe ED. The age-adjusted odds of ED were significantly higher among participants with hypertension (odds ratio [OR] 1.47; 95% confidence intervals [CI] 1.05, 2.07), ischemic heart disease (OR 1.80; 95% CI 1.10, 2.94), and stroke (OR 3.30; 95% CI 1.22, 8.88), and with these conditions and peripheral arterial disease grouped together as CV disease (OR 1.85; 95% CI 1.34, 2.56). Many participants with hyperlipidemia were receiving treatment, and the age-adjusted odds for ED were not significantly higher. The age-adjusted odds of ED among participants with diabetes mellitus were 2.76 (95% CI 1.52, 5.00), and were 3.21 (95% CI 1.03, 10.05) when hypertension and hyperlipidemia were also present.


CONCLUSIONS
The findings support the postulated intimate nexus between ED and CV disease. The adverse effects of age and CV risk factors and disease on erectile function compound each other. The socioeconomic, epidemiologic, and clinical implications are immense.
Chew
Kew-Kim
KK
Keogh Institute for Medical Research, "A" Block, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia;. Electronic address: kewkimchew@hotmail.com.
Bremner
Alexandra
A
School of Population Health, University of Western Australia, Nedlands, Western Australia, Australia.
Jamrozik
Konrad
K
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Earle
Carolyn
C
Keogh Institute for Medical Research, "A" Block, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia.
Stuckey
Bronwyn
B
Keogh Institute for Medical Research, "A" Block, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia;; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;; School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia.
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology; D014904:Western Australia