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Cited by 268Sexual function and dysfunction studiesUrological Disorders and TreatmentsHormonal and reproductive studies

The Prevalence of Erectile Dysfunction in the Primary Care Setting: Importance of Risk Factors for Diabetes and Vascular Disease

Grover, Steven A., Lowensteyn, Ilka, Kaouache, Mohammed, Marchand, Sylvie, Coupal, Louis, DeCarolis, Emidio, Zoccoli, Joseph, Defoy, Isabelle·2006·Archives of Internal Medicine
DOI 10.1001/archinte.166.2.213
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Abstract

BACKGROUND: The prevalence of erectile dysfunction (ED) and associated risk factors has been described in many clinical settings, but there is little information regarding men seen by primary care physicians. We sought to identify independent factors associated with ED in a primary care setting. METHODS: We surveyed a cross-sectional sample of 3921 Canadian men, aged 40 to 88 years, seen by primary care physicians. Participants completed a full medical history, physical examination, and measurement of fasting blood glucose and lipid levels. We used the International Index of Erectile Function to define ED as a score of less than 26 on the erectile function domain. RESULTS: The overall prevalence of ED was 49.4%. The presence of cardiovascular disease (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.16-1.81; P<.01) or diabetes (OR, 3.13; 95% CI, 2.35-4.16; P<.001) increased the probability of ED after adjustment for other confounders. Among those individuals without cardiovascular disease or diabetes, the calculated 10-year Framingham coronary risk (OR, 1.03 per 1% increase; 95% CI, 1.02-1.05; P<.001) and fasting blood glucose levels (OR, 1.14 per 18-mg/dL [1-mmol/L] increase; 95% CI, 1.04-1.24; P<.01) were independently associated with ED. Erectile dysfunction was also independently associated with undiagnosed hyperglycemia (OR, 1.46; 95% CI, 1.02-2.10; P = .04), impaired fasting glucose (OR, 1.26; 95% CI, 1.08-1.46; P = .004), and the metabolic syndrome (OR, 1.45; 95% CI, 1.24-1.69; P<.001). CONCLUSIONS: Cardiovascular disease, diabetes, future coronary risk, and increasing fasting glucose levels are independently associated with ED. It remains to be determined if ED precedes the development of these conditions.

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  • Prediabetes has been found to be associated with decreased heart rate variability, decreased postural changes in heart rate, increased prevalence of erectile dysfunction among men, and a worse profile in tests of sympathetic and parasympathetic function.

    “Prediabetes has been found to be associated with decreased heart rate variability61 (HRV – a marker of parasympathetic function),62–65, decreased postural changes in heart rate,62 increased prevalence of erectile dysfunction among men,66 and a worse profile in tests of sympathetic and parasympathetic function.67”

    From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [66]

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Authors
Grover, S. A., Lowensteyn, I., Kaouache, M., Marchand, S., Coupal, L., DeCarolis, E., Zoccoli, J., & Defoy, I.
Affiliations
Montreal General Hospital (CA)
Corresponding author
Grover, Steven A.
ORCID
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2006-01-23
Volume
166
Issue
2
Pages
213
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.166.2.213
OpenAlex
W2149263243
Cited by
268
References
33
Citations by year
2026: 6 · 2025: 5 · 2024: 11 · 2023: 8 · 2022: 6 · 2021: 11 · 2020: 10 · 2019: 9 · 2018: 9 · 2017: 4 · 2016: 14 · 2015: 20 · 2014: 15 · 2013: 20 · 2012: 15
FWCI
15.72
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Bristol-Myers Squibb
  • Pfizer
  • AstraZeneca
  • Sanofi
  • Pfizer Canada
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Health Sciences › Medicine › Urology › Urological Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
erectile dysfunction, prevalence, primary care, cardiovascular disease, diabetes mellitus, coronary heart disease risk, fasting blood glucose, hyperglycemia, impaired fasting glucose, metabolic syndrome, risk factors, International Index of Erectile Function
MeSH terms
Adult, Aged, Aged, 80 and over, Arteriosclerosis, Canada, Cardiovascular Diseases, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Humans, Erectile Dysfunction, Male, Middle Aged, Primary Health Care, Probability, Prognosis, Risk Factors, Severity of Illness Index, Prevalence, Confidence Intervals, Odds Ratio, Age Distribution

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