Cardiorenal Determinants of Erectile Dysfunction in Primary Prevention: A Cross-Sectional Study

Med Princ Pract. 2018;27(1):73-79. doi: 10.1159/000484949. Epub 2017 Nov 5.

Abstract

Objective: The aim of this study was to investigate the association between the severity of erectile dysfunction (ED), cardiovascular risk, and target organ damage (heart, renal, vascular) in men free of cardiovascular diseases (CVD).

Subjects and methods: ED was assessed using the International Index of Erectile Function (IIEF-5). The study included 182 men: 100 with ED (IIEF mean score ≤21) and 82 without ED (IIEF mean score >21). Ultrasound was used to evaluate carotid plaques and left ventricular mass, geometry, and diastolic function. Cardiovascular anamnesis, CVD risk factors, and anthropometric and biochemical parameters were obtained. The European Society of Cardiology-Systematic Coronary Risk Evaluation Score (ESC-SCORE) was used to calculate total patient cardiovascular risk. Continuous variables between groups were compared using the Student t test and Mann-Whitney U test, while categorical data were compared using the χ2 test. Multiple linear regression was used to test the association between the severity of ED and presence of target organ damage.

Results: The following parameters were significantly higher in the ED group compared to the controls: family history of coronary heart disease (43.7 vs. 26.7%, p = 0.047), ESC-SCORE (2.27 ± 1.79 vs. 1.61 ± 1.13, p = 0.012), and waist circumference (109.28 ± 10.82 vs. 106.17 ± 10.07, p = 0.047). Impaired renal function (p = 0.081), albuminuria (p = 0.545), vascular damage (p = 0.602), and diastolic function (p = 0.724) were similar in both groups. However, left ventricular hypertrophy (LVH; odds ratio 2.231, 95% CI 1.069-4.655, p = 0.22) was more frequent in the ED group (29.9 vs. 16.0%). The multiple linear regression analysis revealed that LVH (β = 1.761, p = 0.002) and impaired renal function assessed using the estimated glomerular filtration rate (<60 mL/min/1.73 m2; β = 6.207, p = 0.0001) were the independent risk factors for severity of ED.

Conclusion: This study showed that LVH and impaired renal function are associated with ED severity.

Keywords: Cardiovascular risk score; Echocardiography; Erectile dysfunction; Left ventricular hypertrophy; Target organ damage.

MeSH terms

  • Aged
  • Blood Glucose
  • Blood Pressure
  • Body Weights and Measures
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Cross-Sectional Studies
  • Erectile Dysfunction / epidemiology*
  • Glomerular Filtration Rate
  • Humans
  • Hypertrophy, Left Ventricular / epidemiology
  • Linear Models
  • Lipids / blood
  • Male
  • Middle Aged
  • Odds Ratio
  • Renal Insufficiency / epidemiology*
  • Renal Insufficiency / physiopathology
  • Risk Factors
  • Severity of Illness Index

Substances

  • Blood Glucose
  • Lipids