Department of Urology, University of Washington, Seattle, WA 98195, USA.
J Sex Med. 2012 Aug;9(8):2104-10. doi: 10.1111/j.1743-6109.2012.02826.x. Epub 2012 Jul 3.
Erectile dysfunction (ED) is a significant problem among aging men. ED is independently associated with cardiovascular (CV) events (angina, myocardial infarction, and stroke).
We sought to determine if ED was associated with CV death.
Risk of CV death in men with ED.
Exactly 31,296 men in Washington aged 50-76 completed a questionnaire in 2000-2002 on supplements, diet, exercise, personal health, and ED. ED was determined by one question: "Have you experienced impotence in the last year?" We excluded patients with a history of coronary artery disease or stroke. Participants linked yearly through 2008 to the Washington State Death Certificate System. CV death was defined by death certificates listing CV-related deaths (International Classification of Diseases 10th Revision [ICD-10] codes: I00-I15, I20-I52, and I60-I99). We performed multivariate Cox proportional hazard regression adjusting for age, marital status, race, education, self-rating of health, body mass index (BMI), antihypertensive/lipid-lowering drug use, diabetes, family history of CV disease, smoking, and exercise.
About 7,762 men had ED and there were 486 CV deaths over 7.8-year average follow-up. The typical man who suffered CV death was older, single, reporting poor health, taking antihypertensives, higher BMI, a smoker, a diabetic, and had a family history of CV disease. When adjusting for age, marital status, and education only, men with ED had a 23% increased risk of CV death (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.01, 1.49). With further adjustment for known risk factors for CV disease (diabetes, treatment for hypertension or hyperlipidemia, family history of myocardial infarction/stroke, BMI, and exercise), ED no longer predicted CV death (HR 0.93, 95% CI 0.76, 1.15).
In this community-based cohort, ED was not independently associated with an elevated risk of CV death. These data do not contradict prior data associating ED and CV events but rather suggest that ED may be a manifestation of other known risk factors for CV disease.
勃起功能障碍（ED）是老年男性的一个严重问题。ED 与心血管（CV）事件（心绞痛、心肌梗死和中风）独立相关。
我们旨在确定 ED 是否与 CV 死亡相关。
ED 男性的 CV 死亡风险。
2000-2002 年，华盛顿州 50-76 岁的 31296 名男性完成了一份关于补品、饮食、运动、个人健康和 ED 的调查问卷。ED 通过一个问题来确定：“您在过去一年中是否经历过阳痿？”我们排除了有冠心病或中风病史的患者。参与者通过与 2008 年华盛顿州死亡证明系统每年联系。CV 死亡由列出 CV 相关死亡的死亡证明定义（国际疾病分类第 10 次修订版[ICD-10]代码：I00-I15、I20-I52 和 I60-I99）。我们通过多变量 Cox 比例风险回归进行分析，调整年龄、婚姻状况、种族、教育程度、自我健康评估、体重指数（BMI）、降压/降脂药物使用、糖尿病、CV 疾病家族史、吸烟和运动。
约 7762 名男性患有 ED，在 7.8 年的平均随访期间发生了 486 例 CV 死亡。患有 CV 死亡的典型男性年龄较大、单身、自述健康状况不佳、服用降压药、BMI 较高、吸烟、患有糖尿病且有 CV 疾病家族史。仅调整年龄、婚姻状况和教育程度后，患有 ED 的男性 CV 死亡风险增加 23%（风险比[HR]1.23，95%置信区间[CI]1.01，1.49）。进一步调整 CV 疾病的已知危险因素（糖尿病、高血压或高脂血症治疗、心肌梗死/中风家族史、BMI 和运动）后，ED 不再预测 CV 死亡（HR 0.93，95%CI 0.76，1.15）。
在这项基于社区的队列研究中，ED 与 CV 死亡风险增加无关。这些数据与先前将 ED 与 CV 事件相关联的数据并不矛盾，而是表明 ED 可能是 CV 疾病其他已知危险因素的表现。
