title: Statin use and incident erectile dysfunction--A nationwide propensity-matched cohort study in Taiwan.
abstract: BACKGROUND
  Statins are commonly prescribed for cardiovascular diseases which have been reported to share many contributory underlying mechanisms with erectile dysfunction (ED). However, the correlation between statin use and incident ED is uncertain.
  
  
  METHODS
  We conducted a population-based propensity-matched cohort study by identifying new statin users among male patients 40-79 years of age in the period 2000 to 2010. A statin nonuser control cohort matched for age, propensity score, and index year at a 3:1 ratio was selected for comparison. Cohorts were tracked for the occurrence of any type of incident ED according to the registry of ED diagnosis in the database. The association between statin use and the risk of ED was evaluated by Cox proportional hazard model and adjusted by age, PS, socioeconomic status, comorbidities, and medications.
  
  
  RESULTS
  Compared with nonusers, statin users had a significantly lower risk of incident ED (HR, 0.75; 95% CI, 0.63-0.90, p=0.002). Further analysis demonstrated that statin users in the group of middle-aged (40-49 years old) or high-potency statin treated (i.e., rosuvastatin, atorvastatin, and simvastatin) had lower HR for incident ED. Analysis in the patterns of cumulative statin exposure also showed that high-potency statins could decrease the HR for incident ED in dose- and duration-dependent manners.
  
  
  CONCLUSIONS
  Statin use was associated with a reduced risk of incident ED in the middle-aged men in Taiwan. The potency and the cumulative exposure of statin utilized played critical roles.
authors.affiliation: Institute of Public Health & Department of Public Health, National Yang Ming University, Taipei, Taiwan.
authors.forename: Chian-Ying
authors.initials: CY
authors.lastname: Chou
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Yang
authors.affiliation: Institute of Public Health & Department of Public Health, National Yang Ming University, Taipei, Taiwan.
authors.forename: Yiing-Jenq
authors.initials: YJ
authors.lastname: Chou
authors.affiliation: Institute of Public Health & Department of Public Health, National Yang Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
authors.affiliation: Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei, Taiwan. Electronic address: syhuang@ym.edu.tw.
authors.forename: Nicole
authors.initials: N
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D057216:Propensity Score; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Erectile dysfunction; Propensity score; Retrospective cohort; Statin