Erectile dysfunction and risk of cardiovascular and all-cause mortality in the general population: a meta-analysis of cohort studies

Abstract

Purpose: Studies on the association of erectile dysfunction (ED) with cardiovascular or all-cause mortality have yielded conflicting findings. We conducted this meta-analysis to evaluate the association of ED with cardiovascular or all-cause mortality in the general population.

Methods: Pubmed and Embase databases were searched for prospective studies that evaluated the association of ED with cardiovascular or all-cause mortality in the general population up to 15 December, 2017. The overall combined risk ratio (RR) and 95% confidence intervals (CI) were pooled for the men with or without ED.

Results: A total of 7 studies involving 111,440 participants were included in the meta-analysis. When compared to the men with or without ED, the overall pooled RR was 1.24 (95% CI 1.11-1.39) for all-cause mortality and 1.11 (95% CI 0.92-1.35) for cardiovascular mortality. Subgroup analyses indicated that only men with severe ED significantly increased all-cause mortality risk (RR 1.58; 95% CI 1.37-1.82), but not in the mild (RR 1.07; 95% CI 0.93-1.24) ED and the moderate (RR 1.16; 95% CI 1.00-1.35) ED.

Conclusions: This meta-analysis suggests that severe ED is significantly associated with increased all-cause mortality in the general population. However, the association of ED with cardiovascular mortality should be further investigated.

Keywords: All-cause mortality; Cardiovascular mortality; Erectile dysfunction; Meta-analysis.