Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)

David I. Feldman; Miguel Cainzos-Achirica; Kevin L. Billups; Andrew P. Defilippis; Kanchan Chitaley; Philip Greenland; James H. Stein; Matthew J. Budoff; Zeina Dardari; Martin Miner; Roger S. Blumenthal; Khurram Nasir; Michael J. Blaha

doi:10.1002/clc.22530

Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)

David I. Feldman, Miguel Cainzos-Achirica, Kevin L. Billups, Andrew P. Defilippis, Kanchan Chitaley, Philip Greenland, James H. Stein, Matthew J. Budoff, Zeina Dardari, Martin Miner, Roger S. Blumenthal, Khurram Nasir, Michael J. Blaha^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

37 Scopus citations

Abstract

Background The association between subclinical cardiovascular disease and subsequent development of erectile dysfunction (ED) remains poorly described. Hypothesis Among multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium (CAC) score best predicts ED. Methods After excluding participants taking ED medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA) with comprehensive baseline subclinical vascular disease phenotyping and ED status assessed at MESA visit 5 (9.4 ± 0.5 years after baseline) using a standardized question on ED symptoms. Multivariable logistic regression was used to assess the associations between baseline measures of vascular disease (atherosclerosis domain: CAC, carotid intima-media thickness, carotid plaque, ankle-brachial index; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow-mediated dilation) and ED symptoms at follow-up. Results Mean baseline age was 59.5 ± 9 years, and 839 participants (45%) reported ED symptoms at follow-up. Compared with symptom-free individuals, participants with ED had higher baseline prevalence of CAC score >100 (36.4% vs 17.2%), carotid intima-media thickness Z score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility <25th percentile (34.6% vs 17.1%), aortic distensibility <25th percentile (34.2% vs 18.7%), and brachial flow-mediated dilation <25th percentile (28.4% vs 21.3%); all P < 0.01. Only CAC >100 (odds ratio: 1.43, 95% confidence interval: 1.09-1.88) and carotid plaque score ≥2 (odds ratio: 1.33, 95% confidence interval: 1.02-1.73) were significantly associated with ED. Conclusions Subclinical vascular disease is common in men who later self-report ED. Early detection of subclinical atherosclerosis, particularly advanced CAC and carotid plaque, may provide opportunities for predicting the onset of subsequent vascular ED.

Original language	English (US)
Pages (from-to)	291-298
Number of pages	8
Journal	Clinical Cardiology
Volume	39
Issue number	5
DOIs	https://doi.org/10.1002/clc.22530
State	Published - May 1 2016

Funding

This research was supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC- 95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040 and UL1-TR-001079 from the National Center for Research Resources. This publication was developed under a STAR research assistance agreement, No. RD831697 (MESA Air), awarded by the US Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication. Dr. Cainzos-Achirica was funded by a research grant from the Spanish Society of Cardiology. The authors have no other funding, financial relationships

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1002/clc.22530

Cite this

Feldman, D. I., Cainzos-Achirica, M., Billups, K. L., Defilippis, A. P., Chitaley, K., Greenland, P., Stein, J. H., Budoff, M. J., Dardari, Z., Miner, M., Blumenthal, R. S., Nasir, K., & Blaha, M. J. (2016). Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA). Clinical Cardiology, 39(5), 291-298. https://doi.org/10.1002/clc.22530

@article{a9ba4046295d40bfae15458e59270006,

title = "Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)",

abstract = "Background The association between subclinical cardiovascular disease and subsequent development of erectile dysfunction (ED) remains poorly described. Hypothesis Among multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium (CAC) score best predicts ED. Methods After excluding participants taking ED medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA) with comprehensive baseline subclinical vascular disease phenotyping and ED status assessed at MESA visit 5 (9.4 ± 0.5 years after baseline) using a standardized question on ED symptoms. Multivariable logistic regression was used to assess the associations between baseline measures of vascular disease (atherosclerosis domain: CAC, carotid intima-media thickness, carotid plaque, ankle-brachial index; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow-mediated dilation) and ED symptoms at follow-up. Results Mean baseline age was 59.5 ± 9 years, and 839 participants (45%) reported ED symptoms at follow-up. Compared with symptom-free individuals, participants with ED had higher baseline prevalence of CAC score >100 (36.4% vs 17.2%), carotid intima-media thickness Z score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility <25th percentile (34.6% vs 17.1%), aortic distensibility <25th percentile (34.2% vs 18.7%), and brachial flow-mediated dilation <25th percentile (28.4% vs 21.3%); all P < 0.01. Only CAC >100 (odds ratio: 1.43, 95% confidence interval: 1.09-1.88) and carotid plaque score ≥2 (odds ratio: 1.33, 95% confidence interval: 1.02-1.73) were significantly associated with ED. Conclusions Subclinical vascular disease is common in men who later self-report ED. Early detection of subclinical atherosclerosis, particularly advanced CAC and carotid plaque, may provide opportunities for predicting the onset of subsequent vascular ED.",

author = "Feldman, {David I.} and Miguel Cainzos-Achirica and Billups, {Kevin L.} and Defilippis, {Andrew P.} and Kanchan Chitaley and Philip Greenland and Stein, {James H.} and Budoff, {Matthew J.} and Zeina Dardari and Martin Miner and Blumenthal, {Roger S.} and Khurram Nasir and Blaha, {Michael J.}",

note = "Publisher Copyright: {\textcopyright} 2016 Wiley Periodicals, Inc.",

year = "2016",

month = may,

day = "1",

doi = "10.1002/clc.22530",

language = "English (US)",

volume = "39",

pages = "291--298",

journal = "Clinical Cardiology",

issn = "0160-9289",

publisher = "John Wiley and Sons Inc.",

number = "5",

}

Feldman, DI, Cainzos-Achirica, M, Billups, KL, Defilippis, AP, Chitaley, K, Greenland, P, Stein, JH, Budoff, MJ, Dardari, Z, Miner, M, Blumenthal, RS, Nasir, K & Blaha, MJ 2016, 'Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)', Clinical Cardiology, vol. 39, no. 5, pp. 291-298. https://doi.org/10.1002/clc.22530

TY - JOUR

T1 - Subclinical Vascular Disease and Subsequent Erectile Dysfunction

T2 - The Multiethnic Study of Atherosclerosis (MESA)

AU - Feldman, David I.

AU - Cainzos-Achirica, Miguel

AU - Billups, Kevin L.

AU - Defilippis, Andrew P.

AU - Chitaley, Kanchan

AU - Greenland, Philip

AU - Stein, James H.

AU - Budoff, Matthew J.

AU - Dardari, Zeina

AU - Miner, Martin

AU - Blumenthal, Roger S.

AU - Nasir, Khurram

AU - Blaha, Michael J.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background The association between subclinical cardiovascular disease and subsequent development of erectile dysfunction (ED) remains poorly described. Hypothesis Among multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium (CAC) score best predicts ED. Methods After excluding participants taking ED medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA) with comprehensive baseline subclinical vascular disease phenotyping and ED status assessed at MESA visit 5 (9.4 ± 0.5 years after baseline) using a standardized question on ED symptoms. Multivariable logistic regression was used to assess the associations between baseline measures of vascular disease (atherosclerosis domain: CAC, carotid intima-media thickness, carotid plaque, ankle-brachial index; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow-mediated dilation) and ED symptoms at follow-up. Results Mean baseline age was 59.5 ± 9 years, and 839 participants (45%) reported ED symptoms at follow-up. Compared with symptom-free individuals, participants with ED had higher baseline prevalence of CAC score >100 (36.4% vs 17.2%), carotid intima-media thickness Z score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility <25th percentile (34.6% vs 17.1%), aortic distensibility <25th percentile (34.2% vs 18.7%), and brachial flow-mediated dilation <25th percentile (28.4% vs 21.3%); all P < 0.01. Only CAC >100 (odds ratio: 1.43, 95% confidence interval: 1.09-1.88) and carotid plaque score ≥2 (odds ratio: 1.33, 95% confidence interval: 1.02-1.73) were significantly associated with ED. Conclusions Subclinical vascular disease is common in men who later self-report ED. Early detection of subclinical atherosclerosis, particularly advanced CAC and carotid plaque, may provide opportunities for predicting the onset of subsequent vascular ED.

AB - Background The association between subclinical cardiovascular disease and subsequent development of erectile dysfunction (ED) remains poorly described. Hypothesis Among multiple subclinical atherosclerosis and vascular dysfunction measurements, coronary artery calcium (CAC) score best predicts ED. Methods After excluding participants taking ED medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA) with comprehensive baseline subclinical vascular disease phenotyping and ED status assessed at MESA visit 5 (9.4 ± 0.5 years after baseline) using a standardized question on ED symptoms. Multivariable logistic regression was used to assess the associations between baseline measures of vascular disease (atherosclerosis domain: CAC, carotid intima-media thickness, carotid plaque, ankle-brachial index; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow-mediated dilation) and ED symptoms at follow-up. Results Mean baseline age was 59.5 ± 9 years, and 839 participants (45%) reported ED symptoms at follow-up. Compared with symptom-free individuals, participants with ED had higher baseline prevalence of CAC score >100 (36.4% vs 17.2%), carotid intima-media thickness Z score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility <25th percentile (34.6% vs 17.1%), aortic distensibility <25th percentile (34.2% vs 18.7%), and brachial flow-mediated dilation <25th percentile (28.4% vs 21.3%); all P < 0.01. Only CAC >100 (odds ratio: 1.43, 95% confidence interval: 1.09-1.88) and carotid plaque score ≥2 (odds ratio: 1.33, 95% confidence interval: 1.02-1.73) were significantly associated with ED. Conclusions Subclinical vascular disease is common in men who later self-report ED. Early detection of subclinical atherosclerosis, particularly advanced CAC and carotid plaque, may provide opportunities for predicting the onset of subsequent vascular ED.

UR - http://www.scopus.com/inward/record.url?scp=84964766163&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964766163&partnerID=8YFLogxK

U2 - 10.1002/clc.22530

DO - 10.1002/clc.22530

M3 - Article

C2 - 27145089

AN - SCOPUS:84964766163

SN - 0160-9289

VL - 39

SP - 291

EP - 298

JO - Clinical Cardiology

JF - Clinical Cardiology

IS - 5

ER -

Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)

Abstract

Funding

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this