Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)

David I. Feldman, Miguel Cainzos-Achirica, Kevin Lenuell Billups, Andrew P. Defilippis, Kanchan Chitaley, Philip Greenland, James H. Stein, Matthew J. Budoff, Zeina Dardari, Martin Miner, Roger S Blumenthal, Khurram Nasir, Michael Blaha

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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±0.5years 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±9years, 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 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.

Original languageEnglish (US)
JournalClinical Cardiology
DOIs
StateAccepted/In press - 2016

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Feldman, D. I., Cainzos-Achirica, M., Billups, K. L., Defilippis, A. P., Chitaley, K., Greenland, P., Stein, J. H., Budoff, M. J., Dardari, Z., Miner, M., Blumenthal, R. S., Nasir, K., & Blaha, M. (Accepted/In press). Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA). Clinical Cardiology. https://doi.org/10.1002/clc.22530