title: Sexual activity, erectile dysfunction, and incident cardiovascular events.
abstract: Although erectile dysfunction (ED) is considered a well-established risk factor for cardiovascular disease (CVD), few studies have investigated whether other aspects of sexual function might predict CVD independently of ED. In a longitudinal, population-based study of community-dwelling men participating in the Massachusetts Male Aging Study, we examined sexual function variables (including ED) and the subsequent development of CVD. ED was defined according to a validated, discriminant-analytic formula determined from the questionnaire responses and categorized as moderate/complete ED versus none/minimal. CVD included a wide range of major end points and was ascertained through self-report, medical records, and the National Death Index. We calculated the age-adjusted incidence rates according to the person-years of follow-up, and Cox proportional hazards models were used to estimate covariate-adjusted, Framingham risk score-adjusted, and ED-adjusted hazard ratios and 95% confidence intervals for sexual function variables and the subsequent risk of CVD. Of the 1,165 men free of CVD at baseline, the age-adjusted CVD incidence rate for moderate/complete ED and none/minimal ED was 17.9/1,000 person-years and 12.5/1,000 person-years, respectively. In multivariate models adjusted for age, covariates, ED, and the Framingham risk score, a low frequency of sexual activity (once a month or less vs >or=2 times weekly) was associated with increased risk of CVD (hazard ratio 1.45, 95% confidence interval 1.04 to 2.01). In conclusion, our results suggest that a low frequency of sexual activity predicts CVD independently of ED and that screening for sexual activity might be clinically useful.
authors.affiliation: New England Research Institutes, Watertown, Massachusetts, USA. shall@neriscience.com
authors.forename: Susan A
authors.initials: SA
authors.lastname: Hall
authors.forename: Rebecca
authors.initials: R
authors.lastname: Shackelton
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
authors.forename: Andre B
authors.initials: AB
authors.lastname: Araujo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010549:Personal Satisfaction; D012307:Risk Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors