Open AccessSubclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis ( MESA )
Author(s) -
Feldman David I.,
CainzosAchirica Miguel,
Billups Kevin L.,
DeFilippis Andrew P.,
Chitaley Kanchan,
Greenland Philip,
Stein James H.,
Budoff Matthew J.,
Dardari Zeina,
Miner Martin,
Blumenthal Roger S.,
Nasir Khurram,
Blaha Michael J.
Publication year - 2016
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22530
Subject(s) - medicine , odds ratio , cardiology , confidence interval , subclinical infection , arterial stiffness , erectile dysfunction , vascular disease , percentile , coronary calcium score , coronary artery disease , blood pressure , coronary artery calcium , statistics , mathematics
ABSTRACT Background The association between subclinical cardiovascular disease and subsequent development of erectile dysfunction ( ED ) remains poorly described. Hypothesis Among multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium ( CAC ) score best predicts ED . Methods After excluding participants taking ED medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi‐Ethnic Study of Atherosclerosis ( MESA ) with comprehensive baseline subclinical vascular disease phenotyping and ED status assessed at MESA visit 5 (9.4 ± 0.5 years after baseline) using a standardized question on ED symptoms. Multivariable logistic regression was used to assess the associations between baseline measures of vascular disease (atherosclerosis domain: CAC , carotid intima‐media thickness, carotid plaque, ankle‐brachial index; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow‐mediated dilation) and ED symptoms at follow‐up. Results Mean baseline age was 59.5 ± 9 years, and 839 participants (45%) reported ED symptoms at follow‐up. Compared with symptom‐free individuals, participants with ED had higher baseline prevalence of CAC score >100 (36.4% vs 17.2%), carotid intima‐media thickness Z score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility <25th percentile (34.6% vs 17.1%), aortic distensibility <25th percentile (34.2% vs 18.7%), and brachial flow‐mediated dilation <25th percentile (28.4% vs 21.3%); all P < 0.01. Only CAC >100 (odds ratio: 1.43, 95% confidence interval: 1.09‐1.88) and carotid plaque score ≥2 (odds ratio: 1.33, 95% confidence interval: 1.02‐1.73) were significantly associated with ED . Conclusions Subclinical vascular disease is common in men who later self‐report ED . Early detection of subclinical atherosclerosis, particularly advanced CAC and carotid plaque, may provide opportunities for predicting the onset of subsequent vascular ED .