title: Relationship between erectile dysfunction and silent myocardial ischemia in type 2 diabetic patients with no known macrovascular complications.
abstract: BACKGROUND
  Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) because it is highly prevalent among those with cardiovascular risk factors (CVRFs). Moreover, it precedes the development of CVD and is considered a subrogate marker of subclinical CVD.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the presence of ED among patients with type 2 diabetes (DM2) without macroangiopathy, and to assess the association between ED and other CVRFs, chronic diabetes complications, silent myocardial ischemia (SMI), and peripheral arterial disease (PAD).
  
  
  METHODS
  One hundred fifty-four male patients with DM2 and without clinical evidence of CVD were included in the study. The presence of ED, PAD, SMI, chronic diabetic complications, and other CVRFs was evaluated in these patients.
  
  
  METHODS
  PAD; SMI; ED; 24-hour blood pressure Holter; lipid profile; insulin resistance; testosterone; chronic inflammation; nephropathy; retinopathy; neuropathy.
  
  
  RESULTS
  Prevalence of ED was 68.2%. Patients with ED were older and characterized by DM2, systolic blood pressure (BP), retinopathy, and insulin treatment of longer duration than patients without ED, even when adjusting for age was performed. Adjusting for duration of diabetic condition revealed significant differences in age and systolic BP. Independent factors for ED were age (57.7±7.5 years, relative risks [RR 1.1], P=0.003) and duration of diabetes (9[3-15] years, RR 1.1, P=0.006). SMI was detected in 13.6% of patients (18.1% in patients with ED vs. 4.1% in patients without ED). Asymptomatic PAD was detected in 13.2% of subjects (14.4% in patients with ED vs. 10.4% in patients without).
  
  
  CONCLUSIONS
  ED is highly prevalent in DM2, and is associated with the presence of SMI, higher systolic BP and chronic microvascular diabetic complications.
authors.affiliation: Department of Endocrinology, Hospital Universitario Dr. Peset, and Department of Medicine, University of Valencia, Valencia, Spain.
authors.forename: Katherine
authors.initials: K
authors.lastname: García-Malpartida
authors.forename: Rosario
authors.initials: R
authors.lastname: Mármol
authors.forename: Ana
authors.initials: A
authors.lastname: Jover
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Gómez-Martínez
authors.forename: Eva
authors.initials: E
authors.lastname: Solá-Izquierdo
authors.forename: Victor M
authors.initials: VM
authors.lastname: Victor
authors.forename: Milagros
authors.initials: M
authors.lastname: Rocha
authors.forename: Darío
authors.initials: D
authors.lastname: Sanmiguel
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández-Mijares
mesh_terms: D000367:Age Factors; D055109:Ankle Brachial Index; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology*; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence