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Men with erectile dysfunction have increased risk for cardiovascular events
24 December 2005
A study, published in the JAMA, found
that men with erectile dysfunction have a higher risk of subsequent
cardiovascular events such as myocardial infarction, stroke, and
angina.
More than 10 million men in the United
States are affected by erectile dysfunction (ED), with an estimated
100 million men affected worldwide.
The risk of erectile
dysfunction is related to many factors, including age, smoking,
diabetes, heart disease, depression, and hypertension.
Because cardiovascular disease and
erectile dysfunction share etiologies as well as pathophysiology
( endothelial dysfunction ) and because of evidence that degree
of erectile dysfunction correlates with severity of cardiovascular
disease, it has been postulated that erectile dysfunction is a sentinel
symptom in patients with cardiovascular disease.
Ian M. Thompson, of the University
of Texas Health Science Center at San Antonio, and colleagues studied
a group of men who were assessed for erectile dysfunction and subsequent
cardiovascular disease over the course of 7 years.
The study included men aged 55 years
or older who were randomized to the placebo group ( n = 9,457 )
in the Prostate Cancer Prevention Trial at 221 U.S. centers. Participants
were evaluated every 3 months for cardiovascular disease and erectile
dysfunction between 1994 and 2003. In analysis, factors at study
entry taken into account included age, body mass index, blood pressure,
serum lipids, diabetes, family history of myocardial infarction,
race, smoking history, current use of antihypertensive medication,
physical activity, and quality of life.
Of the 9,457 men randomized to placebo,
8,063 ( 85 percent ) had no cardiovascular disease at study entry;
of these men, 3,816 ( 47 percent ) had erectile dysfunction at study
entry. Among the 4,247 men without erectile dysfunction at study
entry, 2,420 men ( 57 percent ) reported incident erectile dysfunction
after 5 years. After adjustment, incident erectile dysfunction was
associated with a 25 percent increased risk for subsequent cardiovascular
events during study follow-up. For men with either incident or prevalent
erectile dysfunction, the increased risk was 45 percent.
" Our analysis of men in the
placebo group of this study demonstrates the substantial association
between incident as well as prevalent erectile
dysfunction and subsequent cardiovascular disease, including
angina, myocardial infarction, stroke, and transient ischemic attack,"
the authors write.
" The implications of this study
are substantial. With the availability of effective pharmacotherapy,
an increasing number of men are seeking care for erectile dysfunction.
It is estimated that more than 600,000 men aged 40 to 69 years in
the United States develop erectile dysfunction annually. Our data
suggest that the older men in this group have about a 2-fold greater
risk of cardiovascular disease than younger men without erectile
dysfunction. With 70 percent to 89 percent of sudden cardiac deaths
occurring in men and with many men not having regular physical examinations,
this analysis suggests that the initial presentation of a man with
erectile dysfunction should prompt the evaluating physician to screen
for standard cardiovascular risk factors and, as appropriate, initiate
cardioprotective interventions," they write.
" Our data provide the first
evidence, to our knowledge, of a strong association between erectile
dysfunction and subsequent development of clinical cardiovascular
events. Acknowledging this association over a 5-year period and
the high prevalence of vasculogenic/atherogenic etiologies in men
of this age, the presenting symptom of erectile dysfunction should
prompt an assessment of cardiovascular risk factors and vigorous
interventions as appropriate. While a full cardiovascular evaluation
is not necessary in response to findings of erectile dysfunction
in asymptomatic patients, such findings should prompt diligent observation
of at-risk men and reinforces the need for intervention for cardiovascular
risk factors," the researchers conclude.
Source: American Medical Association,
2005
To read more, visit….. http://www.xagena.it/news/medicinenews_net_news/8cf40e328089249cf77075692aa0c09b.html
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