Erectile dysfunction strong predictor of death, cardiovascular outcomes

Erectile dysfunction (ED) is a strong predictor of death from all causes and of heart attack, stroke and heart failure in men with cardiovascular disease (CVD), German researchers reported in Circulation: Journal of the American Heart Association.

In the first study, researchers found that men with CVD and ED (compared to those without ED) were twice as likely to suffer death from all causes and 1.6 times more likely to suffer the composite of cardiovascular death, heart attack, stroke and heart failure hospitalization. More specifically, they were:

• 1.9 times more likely to die from cardiovascular disease;
• twice as likely to have a heart attack;
• 1.2 times more likely to be hospitalized for heart failure; and
• 1.1 times more likely to have a stroke.

"Erectile dysfunction is something that regularly should be addressed in the medical history of patients; it might be a symptom of early atherosclerosis," said Michael Böhm, M.D., lead author of the study and chairman of internal medicine in the Department of Cardiology and Intensive Care at the University of Saarland, Germany.

The researchers found that patients with ED were older, and had a higher prevalence of hypertension, stroke, diabetes and lower urinary tract surgery than those without ED. Furthermore, 55 percent of the men had ED at entry in the trials.

Deaths from all causes occurred in 11.3 percent of the patients who reported ED at baseline, but in only 5.6 percent of those with no or mild ED at the start of the study. The composite primary outcome of cardiovascular death, heart attack, stroke and heart failure hospitalization occurred in 16.2 percent of ED patients compared to 10.3 percent of patients with no or mild ED.

"It is likely that the presence of ED identified individuals whose cardiovascular disease might be far more advanced than when evaluated with other clinical parameters alone," Böhm said.

Men need to consider ED as a risk factor for cardiovascular disease just as high blood pressure and cholesterol are, Böhm said. "If a man has erectile dysfunction, then he needs to ask his physician to check for other risk factors of cardiovascular disease."