Erectile dysfunction predicts generalised cardiovascular disease: Evidence from a case–control study

Stuckey, Bronwyn G.A.; Walsh, John P.; Ching, Helena L.; Stuckey, Alexander W.; Palmer, Neil R.; Thompson, Peter L.; Watts, Gerald F.

doi:10.1016/j.atherosclerosis.2006.08.043

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Volume 194, Issue 2 , Pages 458-464, October 2007

Erectile dysfunction predicts generalised cardiovascular disease: Evidence from a case–control study

Bronwyn G.A. Stuckey
- Keogh Institute for Medical Research, Nedlands, WA, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, WA, Australia
- School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia
- Corresponding author at: Keogh Institute for Medical Research, Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. Tel.: +61 8 9346 2008; fax: +61 8 9346 3003.
John P. Walsh
- Keogh Institute for Medical Research, Nedlands, WA, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, WA, Australia
- School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia
Helena L. Ching
- Keogh Institute for Medical Research, Nedlands, WA, Australia
Alexander W. Stuckey
- Keogh Institute for Medical Research, Nedlands, WA, Australia
Neil R. Palmer
- Keogh Institute for Medical Research, Nedlands, WA, Australia
Peter L. Thompson
- School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia
- Heart Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
Gerald F. Watts
- School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia

Received 5 June 2006; received in revised form 6 August 2006; accepted 23 August 2006. published online 21 September 2006.

Abstract

Aims

To determine whether idiopathic erectile dysfunction, in the absence of overt cardiovascular disease or cardiovascular risk factors, is associated with vascular or autonomic dysfunction.

Methods

We studied 49 men with ED (without known cardiovascular risk factors or disease) and 50 age-matched controls, aged 40–70 years. Macrovascular endothelial function was examined by brachial artery ultrasonography and microvascular function by venous occlusion plethysmography. Blood pressure measurement and electrocardiography were performed lying and standing, and the 30:15 RR ratio calculated.

Results

Body mass index, testosterone, fasting lipids and glucose did not differ significantly between groups. Standing pulse pressure was higher (50±1mm Hg versus 43±2mm Hg, p<0.004) and 30:15 RR ratio lower (0.97±0.01 versus 1.01±0.01, p<0.02) in the ED group. Flow-mediated dilatation of the brachial artery was not significantly different between groups. Flow debt repayment during forearm reactive hyperaemia was lower in the ED group (7.2±0.7ml versus 9.5±0.8ml per 100ml, p<0.02) than in controls.

Conclusions

Men with idiopathic ED have evidence of endothelial dysfunction in forearm resistance vessels, increased pulse pressure and impaired heart rate variability. This supports the concept that erectile dysfunction is a predictor of cardiovascular dysfunction and a precursor of clinical cardiovascular disease.

Keywords: Erectile dysfunction, Cardiovascular risk, Endothelial function, Vasodilation, Brachial artery, Microcirculation, Heart rate variability, Autonomic nervous system, Age factors