Is Erectile Dysfunction an Indicator for Increased Risk of Coronary Heart Disease and Stroke

Abstract Background: Considered to be a manifestation of a generalized vascular disease, erectile dysfunction (ED) could serve as an indicator for future cardiovascular events. Aim of this study was therefore to evaluate the role of ED as a predictor for coronary heart disease (CHD) and stroke. Methods: Men participating in a health-screening project in the area of Vienna completed the International Index of Erectile Function-5 questionnaire (IIEF5) to assess prevalence and severity of ED. Additionally, all men underwent a detailed health examination. The risk for CHD or stroke within 10 years depending on the severity of ED was estimated according to Framingham risk profile algorithms. Results: In the CHD risk cohort ( n =2.495; 46.2±9.9 yrs) men with moderate/severe ED (IIEF5 5–16; n =163) had a 65% increased relative risk for developing CHD within 10 yrs compared to those without ED (IIEF5 22–25; n =1.784) (absolute risk: 8.0% for no ED to 13.2% for moderate/severe ED; p p =0.121), to 42.2% for 40–49 yrs ( p =0.012), 27.7% for 50–59 yrs ( p =0.048) and 27.1% for 60–69 yrs ( p =0.021). In the stroke risk population ( n =644; 61.3±5.1 yrs) men with moderate/severe ED ( n =99) were at a 43% relative risk increase for a stroke within 10 years (absolute risk: 9.3% for no ED to 13.3% for moderate/severe ED; p =0.041). Increased risk varied between 38.6% for men aged 55–59 yrs ( p =0.013), 24.7% for 60–64 yrs ( p =0.072), 35.9% for 65–69 yrs ( p =0.046) and 43.6% for 70–74 yrs ( p =0.049). Conclusions: Moderate to severe ED, but not mild ED is associated with a considerably increased risk for CHD or stroke within 10 years. A thorough medical surveillance seems therefore advisable for men with ED including cardiological evaluation, treatment of risk factors and lifestyle modifications.