Author + information
- Received September 24, 2009
- Revision received April 15, 2010
- Accepted April 30, 2010
- Published online November 30, 2010.
- G. David Batty, PhD*,†,‡,* (, )
- Qiang Li, MBiostat†,
- Sébastien Czernichow, MD, PhD†,§,
- Bruce Neal, MD, PhD†,
- Sophia Zoungas, MD, PhD†∥,
- Rachel Huxley, PhD†,
- Anushka Patel, MD, PhD†,
- Bastiaan E. de Galan, MD, PhD†,¶,
- Mark Woodward, PhD†,#,
- Pavel Hamet, MD, PhD**,
- Stephen B. Harrap, MD, PhD††,
- Neil Poulter, MD, PhD‡‡,
- John Chalmers, MD, PhD†,
- ADVANCE Collaborative Group
- ↵*Reprint requests and correspondence:
Dr. G. David Batty, UCL Epidemiology and Public Health, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
Objectives The aim of this study was to examine the relationship between erectile problems in men and cardiovascular disease (CVD) mortality.
Background Although there are plausible mechanisms linking erectile dysfunction (ED) with coronary heart disease (CHD) and stroke, studies are scarce.
Methods In a cohort analysis of the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation) trial population, 6,304 men age 55 to 88 years with type 2 diabetes participated in a baseline medical examination when inquiries were made about ED. Over 5 years of follow-up, during which study members attended repeat clinical examinations, the presence of fatal and nonfatal CVD outcomes, cognitive decline, and dementia was ascertained.
Results After adjusting for a range of covariates, including existing illness, psychological health, and classic CVD risk factors, relative to those who were free of the condition, baseline ED was associated with an elevated risk of all CVD events (hazard ratio: 1.19; 95% confidence interval: 1.08 to 1.32), CHD (hazard ratio: 1.35; 95% confidence interval: 1.16 to 1.56), and cerebrovascular disease (hazard ratio: 1.36; 95% confidence interval: 1.11 to 1.67). Men who experienced ED at baseline and at 2-year follow-up had the highest risk for these outcomes.
Conclusions In this cohort of men with type 2 diabetes, ED was associated with a range of CVD events.
The ADVANCE trial was funded by grants from Servier Laboratoriesand the National Health and Medical Research Council of Australia. These sponsors had no role in the design of the study, data collection, data analysis, data interpretation, or the writing of the manuscript. The Management Committee, whose membership did not include any sponsor representatives, had final responsibility for the decision to submit for publication. The Medical Research Council Social and Public Health Sciences Unit receives funding from the Medical Research Counciland the Chief Scientist Office at the Scottish Government Health Directorates. The Centre for Cognitive Ageing and Cognitive Epidemiology is supported by the Biotechnology and Biological Sciences Research Council, the Engineering and Physical Sciences Research Council, the Economic and Social Research Council, the Medical Research Council, and the University of Edinburghas part of the cross-council Lifelong Health and Wellbeing initiative. For complete author disclosures, please see the end of this paper.
- Received September 24, 2009.
- Revision received April 15, 2010.
- Accepted April 30, 2010.
- American College of Cardiology Foundation