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Lifestyle modifications and pharmacotherapy to reduce the risk of cardiovascular disease can also improve sexual function in men who have erectile dysfunction, according to findings from a meta-analysis first posted online Sept. 12 in Archives of Internal Medicine.
Erectile dysfunction (ED), with a prevalence ranging from 12% of men younger than 59 years of age to 42% of men aged 40-70, shares modifiable risks factors with atherosclerosis and coronary artery disease. These factors include hypertension, diabetes, dyslipidemia, cigarette smoking, obesity, metabolic syndrome, and sedentary behavior. ED has a high prevalence in individuals with multiple risk factors for cardiovascular (CV) disease, and its presence may be an early predictor or marker for cardiovascular events.
While clinical trials have shown that modifying lifestyle risks led to improvement in ED, many are limited by a small sample size and single geographic location and have not studied both lifestyle modifications and pharmacotherapy on ED.
So, Dr. Bhanu P. Gupta and colleagues with the Mayo Clinic, Rochester, Minn., conducted a meta-analysis of six previous randomized controlled trials from four countries to evaluate the relationship between lifestyle intervention and pharmaceutical treatment of cardiovascular risk factors and the severity of ED (Arch. Intern. Med. 2011 Sept 12 [doi:10.1001/archinternmed.2011.440]). The six trials, published between 2004 and 2010 examined in the meta-analysis, included a total of 740 participants (374 who received intervention and 366 control subjects), with the number of participants per trial ranging from 12 to 372. Average age of the participants was 55.4 years, and the study duration ranged from 12 to 104 weeks. All studies included in the analysis showed lessening of ED with adoption of a more healthful lifestyle and improvement in blood lipid parameters.
The meta-analysis showed that improvement in CV risk factors was associated with statistically significant improvement in sexual function, as measured by the Internal Index of Erectile Function, or IIEF-5 score, in which a score of 22- 25 points indicates normal erectile function, 17-21 indicates mild ED, 12-16 indicates mild to moderate ED, 8-11 indicates moderate ED, and 7 and below indicates severe ED.
Meta-analysis of all six trials showed a 2.7-point improvement in mean IIEF-5 score. When excluding studies that included use of statin medications, there was a 2.4-point improvement on the IIEF-5 score. Pharmacotherapy targeting CV risk factors demonstrated improvement of 3.1 points.
Typically, a 4-point improvement in the IIEF-5 score is considered the minimal clinically important difference (MCID). However, the MCID varies significantly according to baseline ED severity, ranging from 2.0 for mild ED to 7.0 for severe ED. "Therefore, the results of this analysis regarding the pooled IIEF-5 score improvement of 2.7 points might not translate into clinically important differences for moderate and severe ED," the researchers say. "Nevertheless, the overall weighted mean difference of 2.7 in IIEF-5 score improvement is consistent with significant improvement in mild ED and lesser improvement in more advanced ED."
"The results of the present meta-analysis add to and strengthen existing knowledge that healthy dietary habits and increased physical activity are important components of health to improve quality of life in men by improving sexual health," the researchers say.
The authors had no financial disclosures to report.
Studies have shown a link between unhealthful lifestyles and a poor quality of life. Despite the benefits of lifestyle modification, however, cardiac risk factors are rampant and increasing in Western societies.
Many Americans seek treatment for erectile dysfunction (ED), which may result from vascular, neurological, psychological, and other factors. ED, known to be related to cardiovascular risk factors, may be a marker of cardiac disease. Ischemic stroke, hemorrhagic stroke, congestive heart failure, and ED are among the various lifestyle-related diseases.
The meta-analysis conducted by Dr. Bhanu P. Gupta and colleagues shows how a healthful lifestyle and pharmacotherapy could improve the severity of ED in men as well as the incidence of cerebral vascular disease (Arch. Intern. Med. 2011 Sept 12 [doi:10.1001/archinternmed.2011.440]).
The increasing epidemic of obesity in the United States should serve as a call to physicians to increase their efforts to motivate their patients and the public at large to make even small changes toward healthier lifestyles. These new associations between healthy lifestyles and reducing incidence of stroke, congestive heart failure, and ED can be powerful tools of persuasion.
Dr. Militza Moreno and Dr. Thomas A. Pearson are in the department of community and preventive medicine at the University of Rochester (N.Y.). The authors had no financial disclosures to report, but they are supported, in part by an Institutional Research Career Development Award from the National Heart, Lung, and Blood Institute, a division of the U.S. National Institutes of Health.
Studies have shown a link between unhealthful lifestyles and a poor quality of life. Despite the benefits of lifestyle modification, however, cardiac risk factors are rampant and increasing in Western societies.
Many Americans seek treatment for erectile dysfunction (ED), which may result from vascular, neurological, psychological, and other factors. ED, known to be related to cardiovascular risk factors, may be a marker of cardiac disease. Ischemic stroke, hemorrhagic stroke, congestive heart failure, and ED are among the various lifestyle-related diseases.
The meta-analysis conducted by Dr. Bhanu P. Gupta and colleagues shows how a healthful lifestyle and pharmacotherapy could improve the severity of ED in men as well as the incidence of cerebral vascular disease (Arch. Intern. Med. 2011 Sept 12 [doi:10.1001/archinternmed.2011.440]).
The increasing epidemic of obesity in the United States should serve as a call to physicians to increase their efforts to motivate their patients and the public at large to make even small changes toward healthier lifestyles. These new associations between healthy lifestyles and reducing incidence of stroke, congestive heart failure, and ED can be powerful tools of persuasion.
Dr. Militza Moreno and Dr. Thomas A. Pearson are in the department of community and preventive medicine at the University of Rochester (N.Y.). The authors had no financial disclosures to report, but they are supported, in part by an Institutional Research Career Development Award from the National Heart, Lung, and Blood Institute, a division of the U.S. National Institutes of Health.
Studies have shown a link between unhealthful lifestyles and a poor quality of life. Despite the benefits of lifestyle modification, however, cardiac risk factors are rampant and increasing in Western societies.
Many Americans seek treatment for erectile dysfunction (ED), which may result from vascular, neurological, psychological, and other factors. ED, known to be related to cardiovascular risk factors, may be a marker of cardiac disease. Ischemic stroke, hemorrhagic stroke, congestive heart failure, and ED are among the various lifestyle-related diseases.
The meta-analysis conducted by Dr. Bhanu P. Gupta and colleagues shows how a healthful lifestyle and pharmacotherapy could improve the severity of ED in men as well as the incidence of cerebral vascular disease (Arch. Intern. Med. 2011 Sept 12 [doi:10.1001/archinternmed.2011.440]).
The increasing epidemic of obesity in the United States should serve as a call to physicians to increase their efforts to motivate their patients and the public at large to make even small changes toward healthier lifestyles. These new associations between healthy lifestyles and reducing incidence of stroke, congestive heart failure, and ED can be powerful tools of persuasion.
Dr. Militza Moreno and Dr. Thomas A. Pearson are in the department of community and preventive medicine at the University of Rochester (N.Y.). The authors had no financial disclosures to report, but they are supported, in part by an Institutional Research Career Development Award from the National Heart, Lung, and Blood Institute, a division of the U.S. National Institutes of Health.
Lifestyle modifications and pharmacotherapy to reduce the risk of cardiovascular disease can also improve sexual function in men who have erectile dysfunction, according to findings from a meta-analysis first posted online Sept. 12 in Archives of Internal Medicine.
Erectile dysfunction (ED), with a prevalence ranging from 12% of men younger than 59 years of age to 42% of men aged 40-70, shares modifiable risks factors with atherosclerosis and coronary artery disease. These factors include hypertension, diabetes, dyslipidemia, cigarette smoking, obesity, metabolic syndrome, and sedentary behavior. ED has a high prevalence in individuals with multiple risk factors for cardiovascular (CV) disease, and its presence may be an early predictor or marker for cardiovascular events.
While clinical trials have shown that modifying lifestyle risks led to improvement in ED, many are limited by a small sample size and single geographic location and have not studied both lifestyle modifications and pharmacotherapy on ED.
So, Dr. Bhanu P. Gupta and colleagues with the Mayo Clinic, Rochester, Minn., conducted a meta-analysis of six previous randomized controlled trials from four countries to evaluate the relationship between lifestyle intervention and pharmaceutical treatment of cardiovascular risk factors and the severity of ED (Arch. Intern. Med. 2011 Sept 12 [doi:10.1001/archinternmed.2011.440]). The six trials, published between 2004 and 2010 examined in the meta-analysis, included a total of 740 participants (374 who received intervention and 366 control subjects), with the number of participants per trial ranging from 12 to 372. Average age of the participants was 55.4 years, and the study duration ranged from 12 to 104 weeks. All studies included in the analysis showed lessening of ED with adoption of a more healthful lifestyle and improvement in blood lipid parameters.
The meta-analysis showed that improvement in CV risk factors was associated with statistically significant improvement in sexual function, as measured by the Internal Index of Erectile Function, or IIEF-5 score, in which a score of 22- 25 points indicates normal erectile function, 17-21 indicates mild ED, 12-16 indicates mild to moderate ED, 8-11 indicates moderate ED, and 7 and below indicates severe ED.
Meta-analysis of all six trials showed a 2.7-point improvement in mean IIEF-5 score. When excluding studies that included use of statin medications, there was a 2.4-point improvement on the IIEF-5 score. Pharmacotherapy targeting CV risk factors demonstrated improvement of 3.1 points.
Typically, a 4-point improvement in the IIEF-5 score is considered the minimal clinically important difference (MCID). However, the MCID varies significantly according to baseline ED severity, ranging from 2.0 for mild ED to 7.0 for severe ED. "Therefore, the results of this analysis regarding the pooled IIEF-5 score improvement of 2.7 points might not translate into clinically important differences for moderate and severe ED," the researchers say. "Nevertheless, the overall weighted mean difference of 2.7 in IIEF-5 score improvement is consistent with significant improvement in mild ED and lesser improvement in more advanced ED."
"The results of the present meta-analysis add to and strengthen existing knowledge that healthy dietary habits and increased physical activity are important components of health to improve quality of life in men by improving sexual health," the researchers say.
The authors had no financial disclosures to report.
Lifestyle modifications and pharmacotherapy to reduce the risk of cardiovascular disease can also improve sexual function in men who have erectile dysfunction, according to findings from a meta-analysis first posted online Sept. 12 in Archives of Internal Medicine.
Erectile dysfunction (ED), with a prevalence ranging from 12% of men younger than 59 years of age to 42% of men aged 40-70, shares modifiable risks factors with atherosclerosis and coronary artery disease. These factors include hypertension, diabetes, dyslipidemia, cigarette smoking, obesity, metabolic syndrome, and sedentary behavior. ED has a high prevalence in individuals with multiple risk factors for cardiovascular (CV) disease, and its presence may be an early predictor or marker for cardiovascular events.
While clinical trials have shown that modifying lifestyle risks led to improvement in ED, many are limited by a small sample size and single geographic location and have not studied both lifestyle modifications and pharmacotherapy on ED.
So, Dr. Bhanu P. Gupta and colleagues with the Mayo Clinic, Rochester, Minn., conducted a meta-analysis of six previous randomized controlled trials from four countries to evaluate the relationship between lifestyle intervention and pharmaceutical treatment of cardiovascular risk factors and the severity of ED (Arch. Intern. Med. 2011 Sept 12 [doi:10.1001/archinternmed.2011.440]). The six trials, published between 2004 and 2010 examined in the meta-analysis, included a total of 740 participants (374 who received intervention and 366 control subjects), with the number of participants per trial ranging from 12 to 372. Average age of the participants was 55.4 years, and the study duration ranged from 12 to 104 weeks. All studies included in the analysis showed lessening of ED with adoption of a more healthful lifestyle and improvement in blood lipid parameters.
The meta-analysis showed that improvement in CV risk factors was associated with statistically significant improvement in sexual function, as measured by the Internal Index of Erectile Function, or IIEF-5 score, in which a score of 22- 25 points indicates normal erectile function, 17-21 indicates mild ED, 12-16 indicates mild to moderate ED, 8-11 indicates moderate ED, and 7 and below indicates severe ED.
Meta-analysis of all six trials showed a 2.7-point improvement in mean IIEF-5 score. When excluding studies that included use of statin medications, there was a 2.4-point improvement on the IIEF-5 score. Pharmacotherapy targeting CV risk factors demonstrated improvement of 3.1 points.
Typically, a 4-point improvement in the IIEF-5 score is considered the minimal clinically important difference (MCID). However, the MCID varies significantly according to baseline ED severity, ranging from 2.0 for mild ED to 7.0 for severe ED. "Therefore, the results of this analysis regarding the pooled IIEF-5 score improvement of 2.7 points might not translate into clinically important differences for moderate and severe ED," the researchers say. "Nevertheless, the overall weighted mean difference of 2.7 in IIEF-5 score improvement is consistent with significant improvement in mild ED and lesser improvement in more advanced ED."
"The results of the present meta-analysis add to and strengthen existing knowledge that healthy dietary habits and increased physical activity are important components of health to improve quality of life in men by improving sexual health," the researchers say.
The authors had no financial disclosures to report.
FROM ARCHIVES OF INTERNAL MEDICINE
Major Finding: Lifestyle modifications and pharmacotherapy not only reduce the risk of cardiovascular disease; they can lead to improved sexual functioning in men with erectile dysfunction.
Data Source: Meta-analysis of six randomized controlled clinical trials in four countries.
Disclosures: The authors had no financial disclosures to report.