title: Peripheral Atherosclerosis in Patients With Erectile Dysfunction: A Population-Based Study.
abstract: BACKGROUND
  The presence of erectile dysfunction (ED) could be a warning of vascular disease in different arterial territories.
  
  
  OBJECTIVE
  The aim of this study was to investigate the association between ED and the presence of atherosclerosis in 2 different vascular beds: carotid and lower limbs.
  
  
  METHODS
  A total of 614 volunteers between 45 and 74 years of age (mean age 61.0 years) were randomly selected from the general population. ED was assessed using the International Index of Erectile Function (IIEF-5). Ankle-brachial index (ABI) measurement and carotid atherosclerosis were evaluated by echo-Doppler.
  
  
  METHODS
  Mean carotid intima-media thickness (IMT), prevalence of carotid plaques, mean ABI, and prevalence of ABI < 0.9 were the main outcome measures.
  
  
  RESULTS
  ED was present in 373 subjects (59.7%). Mean carotid IMT was significantly higher in men with ED (0.762 ± 0.151 mm vs 0.718 ± 0.114 mm, P < .001). Also the global prevalence of carotid plaques was more frequent in men with ED (63.8% vs 44.8%, P < .001), even after adjusting by age, cardiovascular risk factors, and ongoing treatment (P = .039). Both the IMT and the prevalence of carotid plaques increased significantly with ED severity (P trend .004 and <.001, respectively). There were no significant differences between groups neither in mean ABI nor in the prevalence of subjects with ABI < 0.9. However, there was a trend to a lower ABI and a higher prevalence of ABI < 0.9 with increasing ED severity.
  
  
  CONCLUSIONS
  In the general population, the presence of ED identifies subjects with higher atherosclerosis burden in carotid arteries but not in the lower extremities.
authors.affiliation: Atherosclerosis Unit, Internal Medicine Department, Hospital Carlos III, Madrid, Spain. Electronic address: clahoz.hcii@salud.madrid.org.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lahoz
authors.affiliation: Atherosclerosis Unit, Internal Medicine Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Mostaza
authors.affiliation: Gerencia Adjunta de Planificación y Calidad, Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Salinero-Fort
authors.affiliation: Atherosclerosis Unit, Internal Medicine Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: García-Iglesias
authors.affiliation: Atherosclerosis Unit, Internal Medicine Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: González-Alegre
authors.affiliation: Atherosclerosis Unit, Internal Medicine Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Estirado
authors.affiliation: Atherosclerosis Unit, Internal Medicine Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Laguna
authors.affiliation: Servicio de Medicina Preventiva, Hospital Universitario La Paz, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: de Burgos-Lunar
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Sánchez-Arroyo
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Concesa
authors.initials: C
authors.lastname: Sabín
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: López
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Cornejo-Del-Río
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Patrón
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Fernández-García
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Fernández-Puntero
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Vicent
authors.affiliation: Hospital Carlos III, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Montesano-Sanchez
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D002339:Carotid Arteries / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D035002:Lower Extremity / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
keywords: Ankle-Brachial Index; Carotid Artery Plaque; Erectile Dysfunction; Intima-Media Thickness