Does erectile dysfunction contribute to cardiovascular disease risk prediction beyond the Framingham risk score?
Open accessAbstract
Objectives This study was designed to determine whether erectile dysfunction (ED) predicts cardiovascular disease (CVD) beyond traditional risk factors.Background Both ED and CVD share pathophysiological mechanisms and often co-occur. It is unknown whether ED improves the prediction of CVD beyond traditional risk factors.Methods This was a prospective, population-based study of 1,709 men (of 3,258 eligible) age 40 to 70 years. The ED data were measured by self-report. Subjects were followed for CVD for an average follow-up of 11.7 years. The association between ED and CVD was examined using the Cox proportional hazards regression model. The discriminatory capability of ED was examined using C statistics. The reclassification of CVD risk associated with ED was assessed using a method that quantifies net reclassification improvement.Results Of the prospective population, 1,057 men with complete risk factor data who were free of CVD and diabetes at baseline were included. During follow-up, 261 new cases of CVD occurred. We found ED was associated with CVD incidence controlling for age (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.05 to 1.90), age and traditional CVD risk factors (HR: 1.41, 95% CI: 1.05 to 1.90), as well as age and Framingham risk score (HR: 1.40, 95% CI: 1.04 to 1.88). Despite these significant findings, ED did not significantly improve the prediction of CVD incidence beyond traditional risk factors.Conclusions Independent of established CVD risk factors, ED is significantly associated with increased CVD incidence. Nonetheless, ED does not improve the prediction of who will and will not develop CVD beyond that offered by traditional risk factors.
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ED is a marker for CVD and a predictor of future events in middle-aged and older men but not beyond that offered by the Framingham risk score.
“ED is a marker for CVD and a predictor of future events in middle-aged and older men but not beyond that offered by the Framingham risk score.182 -184”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [184]
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- Authors
- Araujo, A. B., Hall, S. A., Ganz, P., Chiu, G. R., Rosen, R. C., Kupelian, V., Travison, T. G., & McKinlay, J. B.
- Affiliations
- New England Research Institutes (US)
- San Francisco General Hospital (US)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 55
- Issue
- 4
- Pages
- 350-356
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC2845313
- OpenAlex
- W2035279715
- Cited by
- 153
- References
- 69
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 10 · 2020: 5 · 2019: 5 · 2018: 9 · 2017: 8 · 2016: 17 · 2015: 10 · 2014: 11 · 2013: 16 · 2012: 21
- FWCI
- 12.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (#AG 04673)
- National Institute of Diabetes and Digestive and Kidney Disorders (#DK 44995, #DK 51345)
- Bayer Healthcare
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- erectile dysfunction, cardiovascular disease, cardiovascular risk prediction, Framingham risk score, risk reclassification, net reclassification improvement, men, cardiovascular disease incidence
- MeSH terms
- Adult, Age Factors, Aged, Cardiovascular Diseases, Humans, Erectile Dysfunction, Male, Middle Aged, Prospective Studies, Risk Factors, Multivariate Analysis
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