Thompson Ian M, Tangen Catherine M, Goodman Phyllis J, Probstfield Jeffrey L, Moinpour Carol M, Coltman Charles A
Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
JAMA. 2005 Dec 21;294(23):2996-3002. doi: 10.1001/jama.294.23.2996.
The risk factors for cardiovascular disease and erectile dysfunction are similar.
To examine the association of erectile dysfunction and subsequent cardiovascular disease.
DESIGN, SETTING, AND PARTICIPANTS: Men aged 55 years or older who were randomized to the placebo group (n = 9457) in the Prostate Cancer Prevention Trial at 221 US centers were evaluated every 3 months for cardiovascular disease and erectile dysfunction between 1994 and 2003. Proportional hazards regression models were used to evaluate the association of erectile dysfunction and cardiovascular disease. In an adjusted model, covariates included age, body mass index, blood pressure, serum lipids, diabetes, family history of myocardial infarction, race, smoking history, physical activity, and quality of life.
Erectile dysfunction and cardiovascular disease.
Of the 9457 men randomized to placebo, 8063 (85%) had no cardiovascular disease at study entry; of these men, 3816 (47%) had erectile dysfunction at study entry. Among the 4247 men without erectile dysfunction at study entry, 2420 men (57%) reported incident erectile dysfunction after 5 years. After adjustment, incident erectile dysfunction was associated with a hazard ratio of 1.25 (95% confidence interval [CI], 1.02-1.53; P = .04) for subsequent cardiovascular events during study follow-up. For men with either incident or prevalent erectile dysfunction, the hazard ratio was 1.45 (95% CI, 1.25-1.69; P<.001). For subsequent cardiovascular events, the unadjusted risk of an incident cardiovascular event was 0.015 per person-year among men without erectile dysfunction at study entry and was 0.024 per person-year for men with erectile dysfunction at study entry. This association was in the range of risk associated with current smoking or a family history of myocardial infarction.
Erectile dysfunction is a harbinger of cardiovascular clinical events in some men. Erectile dysfunction should prompt investigation and intervention for cardiovascular risk factors.
心血管疾病和勃起功能障碍的风险因素相似。
研究勃起功能障碍与后续心血管疾病之间的关联。
设计、设置和参与者：1994年至2003年间，美国221个中心的前列腺癌预防试验中被随机分配到安慰剂组（n = 9457）的55岁及以上男性，每3个月接受一次心血管疾病和勃起功能障碍评估。采用比例风险回归模型评估勃起功能障碍与心血管疾病之间的关联。在调整模型中，协变量包括年龄、体重指数、血压、血脂、糖尿病、心肌梗死家族史、种族、吸烟史、身体活动和生活质量。
勃起功能障碍和心血管疾病。
在9457名被随机分配到安慰剂组的男性中，8063名（85%）在研究开始时无心血管疾病；在这些男性中，3816名（47%）在研究开始时有勃起功能障碍。在研究开始时无勃起功能障碍的4247名男性中，2420名（57%）在5年后报告发生了勃起功能障碍。调整后，发生勃起功能障碍与研究随访期间后续心血管事件的风险比为1.25（95%置信区间[CI]，1.02 - 1.53；P = 0.04）。对于有新发或既往勃起功能障碍的男性，风险比为1.45（95%CI，1.25 - 1.69；P < 0.001）。对于后续心血管事件，在研究开始时无勃起功能障碍的男性中，每人年发生心血管事件的未调整风险为0.015，而在研究开始时有勃起功能障碍的男性中为0.024。这种关联处于与当前吸烟或心肌梗死家族史相关的风险范围内。
勃起功能障碍是部分男性心血管临床事件的先兆。勃起功能障碍应促使对心血管风险因素进行调查和干预。
