title: Erectile dysfunction and risk of clinical cardiovascular events: a meta-analysis of seven cohort studies.
abstract: BACKGROUND
  For many years, erectile dysfunction (ED) has been considered as a complication of cardiovascular disease (CVD) or regarded as a late consequence of generalized arterial disease. However, a growing body of evidence suggests that ED is an early manifestation of atherosclerosis and a precursor to systemic vascular disease.
  
  
  OBJECTIVE
  We conducted a meta-analysis to evaluate the association between ED and the risk of CVD events.
  
  
  METHODS
  Relevant studies published between January 1966 and September 2009 were identified by searching Medline, Embase, and The Cochrane Library. Studies were selected using a prior defined criteria. The strength of the relationship between ED and CVD events was assessed by adjusted relative risks (RRs).
  
  
  METHODS
  The adjusted RRs of CVD events.
  
  
  RESULTS
  A total of 45,558 participants from seven cohort studies (eight full-text articles) were identified in this meta-analysis. The studies provided adjusted RRs estimates for ED subjects comparing with health subjects, leading to a pooled adjusted RR of 1.47 (95% confidence interval [CI], 1.29-1.66, P < 0.001; P for heterogeneity = 0.152; I(2)  = 36.2%) for CVD events. The risks of CVD, all-cause mortality and myocardial infarction were 1.41 (95% CI, 1.22-1.64 P < 0.001), 1.23 (95% CI, 1.02-1.48; P = 0.034), and 1.43 (95% CI, 1.10-1.85 P = 0.007), respectively. The overall adjusted RR decreased significant from 1.63 (<7 years) to 1.37 (≥ 7 years) along with the elongation of follow-up.
  
  
  CONCLUSIONS
  There is evidence of an increased risk of CVD events for patients with ED. Patients who are discovered to have ED are supposed to be thoroughly assessed for cardiovascular risk and occult systemic vascular disease.
authors.affiliation: Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Guo
authors.forename: Cun
authors.initials: C
authors.lastname: Liao
authors.forename: Yaguang
authors.initials: Y
authors.lastname: Zou
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.forename: Tieqiu
authors.initials: T
authors.lastname: Li
authors.forename: Qizhao
authors.initials: Q
authors.lastname: Zhou
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Cao
authors.forename: Xiangming
authors.initials: X
authors.lastname: Mao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D018783:Impotence, Vasculogenic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012306:Risk; D055815:Young Adult