Aims Erectile dysfunction is associated with increased risk of cardiovascular disease; however, little is known about patients seeking treatment for erectile dysfunction. This study investigated the risk of cardiovascular disease for patients receiving medication for erectile dysfunction. Methods and results This nationwide cohort study included 71,710 men aged 40-80 years receiving their first erectile dysfunction medication from 2000 to 2012. Their adjusted risk of cardiovascular events in time intervals after the first erectile dysfunction medication was compared to the general male population using multivariate Poisson regression models and was expressed as a risk ratio (RR). The risk for overall cardiovascular disease was decreased in the first 3 years: the RR in the first year was 0.92 (95% confidence interval [CI] 0.87-0.97, p = 0.003; incidence: 23.68 per 1000 patient-years), and after 1-3 years the RR was 0.94 (95% CI 0.90-0.97, p = 0.002; incidence: 24.92 per 1000 patient-years). After 3 years, there was no significant difference. The risk of myocardial infarction was decreased in all time intervals: the RR in the first year was 0.60 (95% CI 0.50-0.73, p < 0.001; incidence: 1.82 per 1000 patient-years), after 1-3 years the RR was 0.72 (95% CI 0.63-0.82, p < 0.001; incidence: 2.16 per 1000 patient-years) and after 3 years the RR was 0.80 (95% CI 0.73-0.88, p < 0.001; incidence: 2.25 per 1000 patient-years). The risk of heart failure was decreased in the first 3 years. Conclusion Receiving medication for erectile dysfunction was associated with a decreased risk of myocardial infarction and cardiovascular diseases for the first 3 years.
Keywords: Erectile dysfunction; cardiovascular disease; myocardial infarction; phosphodiesterase 5 inhibitors.