RIO GRANDE, PUERTO RICO — Erectile dysfunction seems strongly associated with an elevated risk of peripheral arterial disease even after controlling for other risk factors, according to study results involving 175 men aged older than 50 years.
The findings suggest primary care physicians should consider routinely using erectile dysfunction identification tools, such as the Sexual Health Inventory for Men (SHIM) questionnaire, to better identify those at risk for peripheral artery disease (PAD), Dr. J. Travers Edwards Jr. said at the annual meeting of the North American Primary Care Research Group.
“PAD is often missed until severe symptoms present in a family practice office,” said Dr. Edwards, a family physician in Newport News, Va. There seems to be a common pathway to erectile dysfunction (ED) and cardiovascular disease. Previous studies have shown a relationship between ED and angina, and it's been suggested that men who have ED should be screened annualy for coronary artery disease, he said.
Dr. Edwards and his colleagues evaluated men who presented to a regional medical practice and met criteria for ED based on the SHIM. They used the ankle brachial index to diagnose PAD.
The men had presented for an unrelated medical problem. They also had at least one of four additional PAD risk factors: hyperlipidemia, diabetes, hypertension, or tobacco use. Hyperlipidemia was the most common (81%) and hypertension the least common (14%). About a third had diabetes, and about a third were smokers.
About 40% of men had moderate or severe ED. Nine met the criteria for PAD and six of these also met the criteria for severe ED. The association between severe ED and PAD remained significant after controlling for hyperlipidemia, hypertension, diabetes, and tobacco use.
Hyperlipidemia was significantly associated with severe ED. Smoking seemed to be strongly associated with PAD, and dyslipidemia and diabetes were equally associated with ED. Hypertension had no apparent effect on PAD, said Dr. Edwards, who said he had no financial conflicts to disclose.