title: The association between erectile dysfunction and cardiovascular risk in men with Type 2 diabetes in primary care: it is a matter of age.
abstract: OBJECTIVE
  Erectile dysfunction (ED) prevalence is usually based on questionnaires, too elaborate for daily practice. The single question for ED prevalence is unknown. Literature reports an independent association between ED and both cardiovascular disease (CVD) and diabetes. Whether routinely asking men with Type 2 diabetes (DM2) about ED identifies those at elevated risk for CVD is unknown. We assessed cardiovascular risk of DM2 men with ED.
  
  
  METHODS
  This was a cross-sectional study in primary care. During annual check-up, the practice nurse asked 1823 DM2 men: "Do you have erection problems? Yes/no." ED prevalence rate was calculated. Age, medication, and other known factors associated with ED and/or CVD were used in univariate analysis (odds ratio [OR], Student's t test, and Mann-Whitney test). This revealed confounding variables used in the multivariable analysis. The association between ED and history of cardiovascular disease (HCVD) was assessed by logistic regression analysis. In patients with no HCVD, we assessed the association between ED and 10-year United Kingdom Prospective Diabetes Study (UKPDS) coronary heart disease risk by linear regression analysis.
  
  
  RESULTS
  The prevalence of ED in DM2 patients was 41.3%. There was no independent association between ED and HCVD [adjusted OR, 1.2 (95% CI, 0.9-1.5)]. The 10-year UKPDS CHD risk difference between men with and without ED was 5.9% (95% CI, 3.2-8.7), but after adjustment for age, this association disappeared [adjusted risk difference, 0.6% (95% CI, -1.5 to 2.7)].
  
  
  CONCLUSIONS
  The ED prevalence rate assessed by a single question was comparable to that assessed by questionnaires. ED neither did independently relate to patients' cardiovascular history nor to cardiovascular risk.
authors.affiliation: Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. f.g.w.cleveringa@umcutrecht.nl
authors.forename: Frits G W
authors.initials: FG
authors.lastname: Cleveringa
authors.forename: Margriet G G
authors.initials: MG
authors.lastname: Meulenberg
authors.forename: Kees J
authors.initials: KJ
authors.lastname: Gorter
authors.forename: Maureen
authors.initials: M
authors.lastname: van den Donk
authors.forename: Guy E H M
authors.initials: GE
authors.lastname: Rutten
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D048909:Diabetes Complications / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D007172:Erectile Dysfunction / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors