Erectile Dysfunction Severity as a Risk Marker for Cardiovascular Disease Hospitalisation and All-Cause Mortality: A Prospective Cohort Study
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Banks, Emily; Joshy, Grace; Abhayaratna, Walter; Kritharides, Leonard; Macdonald, Peter S.; Korda, Rosemary; Chalmers, John
Description
BACKGROUND Erectile dysfunction is an emerging risk marker for future cardiovascular disease (CVD) events; however, evidence on dose response and specific CVD outcomes is limited. This study investigates the relationship between severity of erectile dysfunction and specific CVD outcomes. METHODS AND FINDINGS We conducted a prospective population-based Australian study (the 45 and Up Study) linking questionnaire data from 2006-2009 with hospitalisation and death data to 30 June and 31 Dec 2010...[Show more]
dc.contributor.author | Banks, Emily | |
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dc.contributor.author | Joshy, Grace | |
dc.contributor.author | Abhayaratna, Walter | |
dc.contributor.author | Kritharides, Leonard | |
dc.contributor.author | Macdonald, Peter S. | |
dc.contributor.author | Korda, Rosemary | |
dc.contributor.author | Chalmers, John | |
dc.date.accessioned | 2015-11-25T00:31:18Z | |
dc.date.available | 2015-11-25T00:31:18Z | |
dc.identifier.issn | 1549-1676 | |
dc.identifier.uri | http://hdl.handle.net/1885/16724 | |
dc.description.abstract | BACKGROUND Erectile dysfunction is an emerging risk marker for future cardiovascular disease (CVD) events; however, evidence on dose response and specific CVD outcomes is limited. This study investigates the relationship between severity of erectile dysfunction and specific CVD outcomes. METHODS AND FINDINGS We conducted a prospective population-based Australian study (the 45 and Up Study) linking questionnaire data from 2006-2009 with hospitalisation and death data to 30 June and 31 Dec 2010 respectively for 95,038 men aged ≥45 y. Cox proportional hazards models were used to examine the relationship of reported severity of erectile dysfunction to all-cause mortality and first CVD-related hospitalisation since baseline in men with and without previous CVD, adjusting for age, smoking, alcohol consumption, marital status, income, education, physical activity, body mass index, diabetes, and hypertension and/or hypercholesterolaemia treatment. There were 7,855 incident admissions for CVD and 2,304 deaths during follow-up (mean time from recruitment, 2.2 y for CVD admission and 2.8 y for mortality). Risks of CVD and death increased steadily with severity of erectile dysfunction. Among men without previous CVD, those with severe versus no erectile dysfunction had significantly increased risks of ischaemic heart disease (adjusted relative risk [RR] = 1.60, 95% CI 1.31-1.95), heart failure (8.00, 2.64-24.2), peripheral vascular disease (1.92, 1.12-3.29), "other" CVD (1.26, 1.05-1.51), all CVD combined (1.35, 1.19-1.53), and all-cause mortality (1.93, 1.52-2.44). For men with previous CVD, corresponding RRs (95% CI) were 1.70 (1.46-1.98), 4.40 (2.64-7.33), 2.46 (1.63-3.70), 1.40 (1.21-1.63), 1.64 (1.48-1.81), and 2.37 (1.87-3.01), respectively. Among men without previous CVD, RRs of more specific CVDs increased significantly with severe versus no erectile dysfunction, including acute myocardial infarction (1.66, 1.22-2.26), atrioventricular and left bundle branch block (6.62, 1.86-23.56), and (peripheral) atherosclerosis (2.47, 1.18-5.15), with no significant difference in risk for conditions such as primary hypertension (0.61, 0.16-2.35) and intracerebral haemorrhage (0.78, 0.20-2.97). CONCLUSIONS These findings give support for CVD risk assessment in men with erectile dysfunction who have not already undergone assessment. The utility of erectile dysfunction as a clinical risk prediction tool requires specific testing. | |
dc.description.sponsorship | JC has received research grants from Servier, administered through the University of Sydney and The George Institute, as principal investigator for the ADVANCE trial and ADVANCE-ON post trial follow-up study, and have received honoraria from Servier for speaking about ADVANCE at Scientific meetings. PM has received payment from Pfizer for giving a lecture on the treatment of pulmonary hypertension. All other authors have declared that no competing interests exist | |
dc.publisher | Public Library of Science | |
dc.rights | © 2013 Banks et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |
dc.source | PLoS Medicine | |
dc.subject | aged | |
dc.subject | aged, 80 and over | |
dc.subject | biological markers | |
dc.subject | cardiovascular diseases | |
dc.subject | confidence intervals | |
dc.subject | erectile dysfunction | |
dc.subject | humans | |
dc.subject | male | |
dc.subject | middle aged | |
dc.subject | new south wales | |
dc.subject | prospective studies | |
dc.subject | risk factors | |
dc.subject | hospitalization | |
dc.subject | severity of illness index | |
dc.title | Erectile Dysfunction Severity as a Risk Marker for Cardiovascular Disease Hospitalisation and All-Cause Mortality: A Prospective Cohort Study | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 10 | |
dc.date.issued | 2013 | |
local.identifier.absfor | 110201 | |
local.identifier.absfor | 111700 | |
local.identifier.absfor | 110300 | |
local.identifier.ariespublication | f5625xPUB2447 | |
local.type.status | Published Version | |
local.contributor.affiliation | Banks, Emily, College of Medicine, Biology and Environment, CMBE Research School of Population Health, Natl Centre for Epidemiology & Population Health, The Australian National University | |
local.contributor.affiliation | Joshy, Grace, College of Medicine, Biology and Environment, CMBE Research School of Population Health, Natl Centre for Epidemiology & Population Health, The Australian National University | |
local.contributor.affiliation | Abhayaratna, Walter, College of Medicine, Biology and Environment, CMBE ANU Medical School, ANU Medical School, The Australian National University | |
local.contributor.affiliation | Kritharides, Leonard , University of Sydney, Australia | |
local.contributor.affiliation | Macdonald, Peter, Victor Chang Cardiac Research Institute, Australia | |
local.contributor.affiliation | Korda, Rosemary, College of Medicine, Biology and Environment, CMBE Research School of Population Health, Natl Centre for Epidemiology & Population Health, The Australian National University | |
local.contributor.affiliation | Chalmers, John P., University of Sydney, Australia | |
local.identifier.essn | 1549-1676 | |
local.bibliographicCitation.issue | 1 | |
local.bibliographicCitation.startpage | e1001372 | |
local.bibliographicCitation.lastpage | 13 | |
local.identifier.doi | 10.1371/journal.pmed.1001372 | |
dc.date.updated | 2015-12-11T07:26:10Z | |
local.identifier.scopusID | 2-s2.0-84873809952 | |
local.identifier.thomsonID | 000314685600011 | |
dcterms.accessRights | Open Access | |
Collections | ANU Research Publications |
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