Does Erectile Dysfunction Contribute to Cardiovascular Disease Risk Prediction Beyond the Framingham Risk Score?

• Published in: Journal of the American College of Cardiology Vol. 55; no. 4; pp. 350 - 356
• Main Authors: Araujo, Andre B., Hall, Susan A., Ganz, Peter, Chiu, Gretchen R., Rosen, Raymond C., Kupelian, Varant, Travison, Thomas G., McKinlay, John B.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 26.01.2010; Elsevier; Elsevier Limited
• Subjects: Adult; Age Factors; Aged; aging; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - complications; Cardiovascular Diseases - etiology; Cholesterol; Drug therapy; erectile dysfunction; Erectile Dysfunction - complications; Health risk assessment; Heart attacks; Humans; Internal Medicine; longitudinal studies; Male; Medical sciences; men; Middle Aged; Multivariate Analysis; Prospective Studies; Risk Factors; United States > US; cardiovascular disease; CI; HR; ICD; erectile dysfunction; CVD; HDL-C; NDI; men; aging; CHD; longitudinal studies; ED; International Classification of Diseases; National Death Index; high-density lipoprotein cholesterol; hazard ratio; coronary heart disease; confidence interval; Vascular disease; Erection disorders; Atherosclerosis; Risk factor; Prediction; Cardiovascular disease; Risk; Circulatory system; Cardiology; Predictive factor; Male genital diseases
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2009.08.058

This study was designed to determine whether erectile dysfunction (ED) predicts cardiovascular disease (CVD) beyond traditional risk factors. Both ED and CVD share pathophysiological mechanisms and often co-occur. It is unknown whether ED improves the prediction of CVD beyond traditional risk factors. This was a prospective, population-based study of 1,709 men (of 3,258 eligible) age 40 to 70 years. The ED data were measured by self-report. Subjects were followed for CVD for an average follow-up of 11.7 years. The association between ED and CVD was examined using the Cox proportional hazards regression model. The discriminatory capability of ED was examined using C statistics. The reclassification of CVD risk associated with ED was assessed using a method that quantifies net reclassification improvement. Of the prospective population, 1,057 men with complete risk factor data who were free of CVD and diabetes at baseline were included. During follow-up, 261 new cases of CVD occurred. We found ED was associated with CVD incidence controlling for age (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.05 to 1.90), age and traditional CVD risk factors (HR: 1.41, 95% CI: 1.05 to 1.90), as well as age and Framingham risk score (HR: 1.40, 95% CI: 1.04 to 1.88). Despite these significant findings, ED did not significantly improve the prediction of CVD incidence beyond traditional risk factors. Independent of established CVD risk factors, ED is significantly associated with increased CVD incidence. Nonetheless, ED does not improve the prediction of who will and will not develop CVD beyond that offered by traditional risk factors.