Erectile Dysfunction is a risk factor for cardiovascular disease and mortality

More evidence that erectile dysfunction is a risk factor for cardiovascular disease is presented in a study just published in PLoS Medicine (Public Library of Science). This should come as no surprise considering that health of vascular  endothelium is one of the elements necessary to ensure blood delivery to the 'periphery'. The authors added to literature on this topic by examining the degree of erectile dysfunction in relation to cardiovascular risk:

"Erectile dysfunction is an emerging risk marker for future cardiovascular disease (CVD) events; however, evidence on dose response and specific CVD outcomes is limited. This study investigates the relationship between severity of erectile dysfunction and specific CVD outcomes."

To do so they examined hospitalisation and death data for 95,038 men 45 years and older, analyzing the relationship of reported severity of erectile dysfunction to all-cause mortality and hospitalisation for cardiovascular disease. Men with and without previous CVD were, adjusting for age, smoking, alcohol consumption, marital status, income, education, physical activity, body mass index, diabetes, and treatment for hypertension and/or high cholesterol. The data describe a strong association:

"There were 7,855 incident admissions for CVD and 2,304 deaths during follow-up (mean time from recruitment, 2.2 y for CVD admission and 2.8 y for mortality). Risks of CVD and death increased steadily with severity of erectile dysfunction. Among men without previous CVD, those with severe versus no erectile dysfunction had significantly increased risks of ischaemic heart disease (adjusted relative risk [RR] = 1.60), heart failure (8.00), peripheral vascular disease (1.92), “other” CVD (1.26), all CVD combined (1.35), and all-cause mortality (1.93). For men with previous CVD, corresponding RRs (95% CI) were 1.70, 4.40, 2.46, 1.40, 1.64, and 2.37, respectively. Among men without previous CVD, RRs of more specific CVDs increased significantly with severe versus no erectile dysfunction, including acute myocardial infarction (1.66), atrioventricular and left bundle branch block (6.62), and (peripheral) atherosclerosis (2.47), with no significant difference in risk for conditions such as primary hypertension (0.61) and intracerebral haemorrhage (0.78)."

Clinicians' notes: (1) Phosphodiesterase type 5 inhibitors (Viagra®, etc.) do not remediate the underlying causes. (2) Don't forget to check ADMA (asymmetric dimethyl arginine levels for endothelial nitric oxide capacity. As authors conclude, erectile dysfunction is an alert to examine all the risk factors for CVD:

"These findings give support for CVD risk assessment in men with erectile dysfunction who have not already undergone assessment...The findings of this study highlight the need to consider erectile dysfunction in relation to the risk of a wide range of CVDs that extends beyond ischaemic heart disease and stroke and includes conditions such as heart failure and conduction disorders. They also provide evidence that CVD risk is elevated across a spectrum of severity of erectile dysfunction and that men with mild or moderate erectile dysfunction should be considered at increased risk, in addition to those with severe disease."