A cross-sectional observation to investigate subsequent cardiovascular diseases in Taiwanese men with erectile dysfunction

Background: Erectile dysfunction (ED) is regarded as a warning of systemic disease. Controversy still exists in the relationship between ED and subsequent cardiovascular disease (CVD). This study aims to investigate the incidence and the interval of subsequent CVD in Taiwanese men who initially presented with the complaint of ED. Materials and Methods: Consecutive ED patients without a history of obvious CVD at outpatient clinics from 1999 to 2013 were enrolled in the study. Data were collected by chart review and a structured interview through telephone calling. The main outcome measures were incidence and interval of subsequent CVD after the initial presentation of ED. Results: During the study period, a total of 4713 patients presented at our clinics with the complaint of ED. After excluding patients who reported a history of major CVD (n = 347), younger than 40 years old (n = 484), and who did not have follow-up visit and could not be contacted (n = 409), 3473 patients' data (73.7%) were found eligible for analysis. Their mean age was 62.2 +/- 11.2 years (range: 40-91 years), and the mean follow-up period was 82.5 +/- 51.8 months (range: 1-173 months). Of them, 9.1% (n = 316) had subsequent CVD with an ED-coronary artery disease temporal relationship of 58.7 +/- 36.4 months (range: 1-170 months). Patients with subsequent CVD had a higher proportion of diabetes, hypertension (HT), and dyslipidemia compared with those who were free of subsequent CVD (P < 0.05). Age and comorbidities are independent risk factors for subsequent CVD in men with ED (P < 0.001). Of them, 7.4% (n = 258) expired, with malignancy (38.0%), infection (20.0%), and CVD (15.5%) being the three leading causes of death. Conclusions: Among patients with ED, old age and having diabetes, HT, and dyslipidemia are associated with subsequent CVD. CVD risk reduction to halt the progress by lifestyle modification and well control of comorbidities should be advised to ED patients.