ED signals increased risk of dying over 2.8 year period

Friday, February 1, 2013. A large study published on January 29, 2013 in the journal PLoS Medicine reveals a significantly greater risk of heart disease and death from any cause over a 2.8 year average follow-up period among middle-aged and older men experiencing erectile dysfunction (ED).

Australian researchers analyzed data from 95,038 men who participated in the 45 and Up Study of residents of New South Wales. Erectile dysfunction was graded as none, mild, moderate or severe based on questionnaire responses. Hospital admission data reported 7,855 subsequent cardiovascular disease admissions among the current study's subjects over a 2.2 year average period, and 2,304 deaths were documented over 2.8 years of follow-up.

An increased risk of having cardiovascular disease or dying from any cause was observed in association with ED severity. Among men who did not have previous cardiovascular disease diagnoses, those classified as having severe ED had a 60 percent greater risk of ischemic heart disease, an eight times greater risk of heart failure, a 92 percent higher risk of peripheral vascular disease and a 93 percent greater chance of dying over follow-up in comparison with men who did not report ED. Specific cardiac conditions including acute myocardial infarction, atrioventricular and left bundle branch block, and peripheral atherosclerosis were also increased in this group. For those with previous cardiovascular disease diagnoses, the risk of ischemic heart disease was 70 percent higher, heart failure risk was 4.4 times greater, peripheral vascular disease risk was 2.46 percent higher and the risk of dying was more than twice as high over follow-up.

"The current study is an order of magnitude larger than any previous prospective study of erectile dysfunction and cardiovascular known to us, and provides the strongest evidence to date of a relationship of increasing cardiovascular disease risk with increasing self-reported severity of erectile dysfunction," the authors announce. "Although heart failure is often a consequence of ischaemic heart disease, our finding on the relationship between severity of erectile dysfunction and future admissions for heart failure is, to our knowledge, novel and warrants further investigation, given that this condition is common and results in a considerable burden of disease."

"The risks of future heart disease and premature death increased steadily with severity of erectile dysfunction, both in men with and without a history of cardiovascular disease," stated lead author Emily Banks of the National Centre for Epidemiology and Population Health at Australian National University in Canberra. "Rather than causing heart disease, erectile dysfunction is more likely to be a symptom or signal of underlying 'silent' heart disease and could in future become a useful marker to help doctors predict the risk of a cardiovascular problem. This is a sensitive topic but men shouldn't suffer in silence; there are many effective treatments, both for erectile dysfunction and for cardiovascular disease."