Presentation Authors: Edoardo Pozzi*, Paolo Capogrosso, Eugenio Ventimiglia, Walter Cazzaniga, Luca Boeri, Nicolò Schifano, Francesco Chierigo, Rani Zuabi, Federico Dehò, Milan, Italy, Vincenzo Mirone, Naples, Italy, Franco Gaboardi, Francesco Montorsi, Andrea Salonia, Milan, Italy
Introduction: Erectile dysfunction (ED) is widely considered an early manifestation of cardiovascular diseases (CVD), sharing similar risk factors. We sought to identify those patients at higher risk of further developing CVD and/or hypertension (HTN) over time.
Methods: Complete data of 108 consecutive patients presenting between 2005-2011 with ED as their primary compliant were analyzed. All patients were free from CVD and HTN at baseline. Patients completed the International Index of Erectile Function (IIEF) at baseline, and were followed every 6 months with clinical assessment or phone interview. Kaplan-Meier analyses estimated the probability of developing CVD and HTN over time. Cox-regression models were used to test the association between patient baseline characteristics (age, Charlson Comorbidity Index (CCI), baseline IIEF-EF, ED severity, alcohol intake, smoking), PDE5is response and the risk of developing CVD/HTN.
Results: Of all, 43 (40%) patients showed IIEF-EF scores suggestive of severe ED; 37 (39%) and 59 (61%) were non responders and responders to PDE5i, respectively. Median (IQR) follow-up was 95 (86-106) months. Overall, the estimated risk of developing CVD/HTN was 15% (95% CI: 9-27) at 10 years. Those with severe ED had a higher risk of developing CVD/HTN [34% (p=0.03; 95% CI: 17-59)] at 10-year as compared with patients with mild to moderate ED [5% (95%CI: 2-14; Figure 1]. At cox regression analysis, severe ED (HR 4.62, 95%CI: 1.43, 8.89, p=0.01) and baseline IIEF-EF score (HR 0.92, 95% CI: 0.86, 0.99, p=0.02) were associated to the risk of CVD/HTN overtime. Conversely, age and being non-responders to PDE5is (HR 0.92, 95%CI: 0.32, 2.68, p=0.9) were not associated to a risk of CVD/HTN over time.
Conclusions: Patients with severe ED and lower baseline IIEF-EF have more than 30% risk of developing CVD and HTN in 10-years time. Those patients may benefit from medical preventive strategies to lowering the risk of CV events and HTN.