title: Erectile Dysfunction is Predictive of Endothelial Dysfunction in a Well Visit Population.
abstract: The relationship between erectile dysfunction and endothelial dysfunction has been described and is associated with adverse cardiac events. Endothelial dysfunction is believed to precede erectile dysfunction. Our objective was to characterize the prevalence of subjective erectile dysfunction, endothelial dysfunction and commonly related comorbidities in a population of men undergoing wellness screening.
  
  
  
  A total of 205 men presented for wellness screening. They underwent testing for endothelial dysfunction via peripheral arterial tonometry and completed a health screening questionnaire. Reactive hyperemia index scores were generated by peripheral arterial tonometry testing. A reactive hyperemia index score of 1.67 or less defined endothelial dysfunction. The Student t-test and Fisher exact test were performed for continuous and categorical variables, respectively. The association of endothelial dysfunction, erectile dysfunction and various comorbidities was calculated using univariate and multivariable analyses.
  
  
  
  Of 205 men 47 reported subjective erectile dysfunction. Median age was 44 years old. The mean reactive hyperemia index in patients with erectile dysfunction was significantly lower than in patients without erectile dysfunction (1.63 vs 1.87, p = 0.001). Endothelial dysfunction was more common in men with than without erectile dysfunction (55% vs 36%, p = 0.027). Multivariable analysis revealed that men with erectile dysfunction and obesity were twofold more likely to have concomitant endothelial dysfunction (OR 2.45, 95% CI 1.13-4.24, p = 0.02 and OR 2.08, 95% CI 1.16-3.75, p = 0.01, respectively).
  
  
  
  Among middle-aged men presenting for wellness screening erectile dysfunction and obesity independently predicted endothelial dysfunction, a known risk factor for long-term adverse cardiac events.
authors.affiliation: Department of Urology, Winston Salem, North Carolina.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Peyton
authors.affiliation: Department of Urology, Winston Salem, North Carolina.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Colaco
authors.affiliation: Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Robert Caleb
authors.initials: RC
authors.lastname: Kovell
authors.affiliation: Wake Forest School of Medicine, Winston Salem, North Carolina.
authors.forename: Jung H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Urology, Winston Salem, North Carolina. Electronic address: rterleck@wakehealth.ed.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Terlecki
mesh_terms: D000328:Adult; D004730:Endothelium, Vascular / Q000503:physiopathology*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006293:Health Promotion; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014652:Vascular Diseases / Q000150:complications / Q000453:epidemiology*
keywords: endothelium; erectile dysfunction; hyperemia; obesity; penis