Erectile dysfunction predicts generalised cardiovascular disease: Evidence from a case-control study

Aims: To determine whether idiopathic erectile dysfunction, in the absence of overt cardiovascular disease or cardiovascular risk factors, is associated with vascular or autonomic dysfunction. Methods: We studied 49 men with ED (without known cardiovascular risk factors or disease) and 50 age-matched controls, aged 40-70 years. Macrovascular endothelial function was examined by brachial artery ultrasonography and microvascular function by venous occlusion plethysmography. Blood pressure measurement and electrocardiography were performed lying and standing, and the 30:15 RR ratio calculated. Results: Body mass index, testosterone, fasting lipids and glucose did not differ significantly between groups. Standing pulse pressure was higher (50 +/- 1 mm Hg versus 43 +/- 2 mm Hg, p < 0.004) and 30:15 RR ratio lower (0.97 +/- 0.01 versus 1.01 +/- 0.01, p < 0.02) in the ED group. Flow-mediated dilatation of the brachial artery was not significantly different between groups. Flow debt repayment during forearm reactive hyperaemia was lower in the ED group (7.2 +/- 10.7 ml versus 9.5 +/- 0.8 ml per 100 ml, p < 0.02) than in controls. Conclusions: Men with idiopathic ED have evidence of endothelial dysfunction in forearm resistance vessels, increased pulse pressure and impaired heart rate variability. This supports the concept that erectile dysfunction is a predictor of cardiovascular dysfunction and a precursor of clinical cardiovascular disease. (c) 2006 Elsevier Ireland Ltd. All rights reserved.