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

Research output: Contribution to journalArticle

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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Erectile Dysfunction
Vascular Diseases
Atherosclerosis
Coronary Vessels
Calcium
Carotid Intima-Media Thickness
Vascular Stiffness
Blood Vessels
Cardiovascular Diseases
Odds Ratio
Confidence Intervals
Ankle Brachial Index
Self Report
Dilatation
Arm
Logistic Models

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Feldman, D. I., Cainzos-Achirica, M., Billups, K. L., Defilippis, A. P., Chitaley, K., Greenland, P., ... 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

Subclinical Vascular Disease and Subsequent Erectile Dysfunction : The Multiethnic Study of Atherosclerosis (MESA). / Feldman, David I.; Cainzos-Achirica, Miguel; Billups, Kevin Lenuell; Defilippis, Andrew P.; Chitaley, Kanchan; Greenland, Philip; Stein, James H.; Budoff, Matthew J.; Dardari, Zeina; Miner, Martin; Blumenthal, Roger S; Nasir, Khurram; Blaha, Michael.

In: Clinical Cardiology, 2016.

Research output: Contribution to journalArticle

Feldman, DI, Cainzos-Achirica, M, Billups, KL, Defilippis, AP, Chitaley, K, Greenland, P, Stein, JH, Budoff, MJ, Dardari, Z, Miner, M, Blumenthal, RS, Nasir, K & Blaha, M 2016, 'Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)', Clinical Cardiology. https://doi.org/10.1002/clc.22530
Feldman, David I. ; Cainzos-Achirica, Miguel ; Billups, Kevin Lenuell ; Defilippis, Andrew P. ; Chitaley, Kanchan ; Greenland, Philip ; Stein, James H. ; Budoff, Matthew J. ; Dardari, Zeina ; Miner, Martin ; Blumenthal, Roger S ; Nasir, Khurram ; Blaha, Michael. / Subclinical Vascular Disease and Subsequent Erectile Dysfunction : The Multiethnic Study of Atherosclerosis (MESA). In: Clinical Cardiology. 2016.
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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.",
author = "Feldman, {David I.} and Miguel Cainzos-Achirica and Billups, {Kevin Lenuell} and Defilippis, {Andrew P.} and Kanchan Chitaley and Philip Greenland and Stein, {James H.} and Budoff, {Matthew J.} and Zeina Dardari and Martin Miner and Blumenthal, {Roger S} and Khurram Nasir and Michael Blaha",
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T1 - Subclinical Vascular Disease and Subsequent Erectile Dysfunction

T2 - The Multiethnic Study of Atherosclerosis (MESA)

AU - Feldman, David I.

AU - Cainzos-Achirica, Miguel

AU - Billups, Kevin Lenuell

AU - Defilippis, Andrew P.

AU - Chitaley, Kanchan

AU - Greenland, Philip

AU - Stein, James H.

AU - Budoff, Matthew J.

AU - Dardari, Zeina

AU - Miner, Martin

AU - Blumenthal, Roger S

AU - Nasir, Khurram

AU - Blaha, Michael

PY - 2016

Y1 - 2016

N2 - 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.

AB - 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.

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