ED May Indicate Subclinical Cardiovascular Disease

A new study suggests a novel risk factor for cardiovascular disease (CVD), erectile dysfunction (ED), which may share shared mechanisms.

Researchers at Florida International University (FIU; Miami, USA), Baptist Health South Florida (Miami, FL, USA), and other institutions, searched multiple databases for studies examining the association of ED and known measures of subclinical CVD, such as endothelial dysfunction, indicated by flow-mediated dilation (FMD); carotid intima media thickness (cIMT); coronary artery calcification (CAC); and other measures of vascular function, such as the ankle–brachial index, toe–brachial index, and pulse wave velocity.


Following a systematic review and meta-analysis of 28 studies, the researchers found ED was associated with a 2.64% reduction in brachial FMD (as measured by ultrasound), and a 0.09 mm higher cIMT (an early manifestation of atherosclerosis), than those without ED. In subgroup analyses, mean age, study quality, and ED assessment questionnaire did not significantly affect the relationship between ED and cIMT, or between ED and FMD. The association between ED and CAC was also inconclusive. The study was published on December 15, 2017, in Vascular Medicine.

“Our study confirms an association between ED and subclinical CVD, and may shed additional light on the shared mechanisms between ED and CVD,” concluded lead author Chukwuemeka Osondu, MD, MPH, of Baptist Health South Florida. “Measures of erectile dysfunction could be a simple effective CVD risk stratification tool, particularly in young men who are less likely to undergo aggressive CVD risk assessment and management.”

“The presence of erectile dysfunction portends a higher risk of future cardiovascular events, particularly in intermediate risk men, and may serve as an opportunity for intensification of cardiovascular risk prevention strategies,” wrote Naomi Hamburg, MD, and Matt Kluge, MD, of Boston University (MA, USA), in an accompanying editorial. “The findings add to the growing evidence supporting additional trials to determine the clinical impact of erectile dysfunction screening.”

ED, also known as impotence, is characterized by the inability to develop or maintain an erection during sexual activity. The most important organic causes of ED are CVD and diabetes, neurological problems such as trauma from prostatectomy surgery, hormonal insufficiencies (such as hypogonadism) and drug side effects.

Related Links:
Florida International University
Baptist Health South Florida