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. 2015 Jan;12(1):100-8.
doi: 10.1111/jsm.12715. Epub 2014 Oct 8.

Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey

Shona C Fang  1 , Raymond C Rosen, Joseph A Vita, Peter Ganz, Varant Kupelian
Affiliations

Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey

Shona C Fang et al. J Sex Med. 2015 Jan.

Abstract

Introduction: Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear.

Aim: The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk.

Methods: We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years).

Main outcome measures: Framingham CVD risk and change in Framingham CVD risk were the main outcome measures.

Results: Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men.

Conclusions: Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years.

Keywords: Changes in Erectile Function; Male; Prospective Cohort; Sexual Dysfunction.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Study design and data collection scheme. Variables used in models are in bold and underlined.
Figure 2
Figure 2
Difference in Framingham CVD risk (%) in men with transient and persistent ED compared to men without ED (all ages and stratified by age). Bars represent 95% CIs. Results are from unadjusted, age-adjusted, and multivariable-adjusted (demographics, lifestyle factors and baseline Framingham CVD risk) linear regression models. Men with transient and persistent ED over time had greater Framingham CVD risk compared to men without ED. Associations remained significant in men under 50 years after adjusting for baseline Framingham risk, but not in men over 50 years.
Figure 3
Figure 3
Difference in change in Framingham CVD risk over time (%) in men with transient and persistent ED compared to men without ED (all ages and stratified by age). Bars represent 95% CIs. Results are from unadjusted and multivariable-adjusted (demographics and lifestyle factors) linear regression models. Both transient and persistent ED were associated with a greater change in Framingham risk over time in men under 50 years, but not over 50 years.
See this image and copyright information in PMC

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