Frantzen J, Speel T G W, Kiemeney L A, Meuleman E J H
Radboud University Medical Centre, Nijmegen, the Netherlands.
Ann Epidemiol. 2006 Feb;16(2):85-90. doi: 10.1016/j.annepidem.2005.06.047. Epub 2005 Oct 12.
The introduction of sildenafil put the risk of cardiovascular disease (CVD) among men with erectile dysfunction (ED) on the agenda of physicians. The question arose, Is EDsentinel to CVD? We sought to answer this question in the present study.
A historical cohort study was set up using medical records of general practices all over the Netherlands. Incident cases of ED were selected before and after the introduction of sildenafil using a catchment population of 60,000 men aged 35 to 74 years. Two to three men without ED (controls) were, subsequently, matched to each case. Incidence of CVD was determined for cases and controls, respectively.
Overall, incidence of ED doubled from 5.3 per 1000 men-years in the period before introduction of sildenafil to 10.1 after the introduction. The relative risk of incident CVD among men with ED compared to controls was 1.7 [95%-CI 0.9-3.3] before the introduction and 1.1 [95%-CI 0.6-1.8] afterwards.
While ED could be seen as a marker for CVD before the introduction of sildenafil, it was clearly not afterwards.
西地那非的引入使勃起功能障碍（ED）男性患心血管疾病（CVD）的风险成为医生们关注的议题。问题随之而来，ED是CVD的先兆吗？我们试图在本研究中回答这个问题。
利用荷兰各地全科医疗的病历建立一项历史性队列研究。在引入西地那非之前和之后，从60000名年龄在35至74岁的男性人群中选取ED的新发病例。随后，为每个病例匹配两到三名无ED的男性（对照）。分别确定病例组和对照组的CVD发病率。
总体而言，ED的发病率从引入西地那非之前的每1000人年5.3例增加了一倍，至引入后为每1000人年10.1例。引入西地那非之前，ED男性发生CVD的相对风险与对照组相比为1.7[95%可信区间0.9 - 3.3]，引入之后为1.1[95%可信区间0.6 - 1.8]。
在引入西地那非之前，ED可被视为CVD的一个标志，但在引入之后显然并非如此。
