HHS Public Access Author manuscript Author Manuscript
Clin Cardiol. Author manuscript; available in PMC 2017 May 03. Published in final edited form as: Clin Cardiol. 2016 May ; 39(5): 291–298. doi:10.1002/clc.22530.
Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multi-Ethnic Study of Atherosclerosis (MESA) David I. Feldman, BS1, Miguel Cainzos-Achirica, MD1,2, Kevin L. Billups, MD1,3, Andrew P. DeFilippis, MD1,4, Kanchan Chitaley, PhD5, Philip Greenland, MD6, James H. Stein, MD7, Matthew J. Budoff, MD8, Zeina Dardari, MSc1, Martin Miner, MD9, Roger S. Blumenthal, MD1, Khurram Nasir, MD, MPH1,10, and Michael J. Blaha, MD, MPH1
Author Manuscript
1Ciccarone
Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, MD
2Welch
Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 3The
James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD
4University
of Louisville, KentuckyOne Health - Jewish Hospital, Louisville, KY
5Department
of Environmental and Occupational Health Sciences, University of Washington,
Seattle, WA 6Departments
Author Manuscript
of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 7Cardiovascular
Medicine Division, University of Wisconsin School of Medicine and Public Health,
Madison, WI 8Department
of Internal Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Torrance,
CA 9Department 10Baptist
of Family Medicine, The Alpert Medical School of Brown University, Providence, RI
Health South Florida, Miami, FL
Abstract
Author Manuscript
Background—To study the association between subclinical vascular disease and subsequent development of erectile dysfunction (ED). Hypothesis—Among a number of subclinical atherosclerosis and vascular dysfunction measurements, the coronary artery calcium (CAC) score is the best predictor of erectile dysfunction. Methods—After excluding participants taking ED medications at baseline, we studied 1,862 men aged 45-84 years free of known CVD from the prospective Multi-Ethnic Study of Atherosclerosis
Corresponding Author: Dr. Michael J. Blaha, MD, MPH, Carnegie 565A – The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, Phone: 443-287-4960, Fax: 410-614-9190, ; Email: [email protected] Disclosures: None of the authors report conflicts of interest pertaining to this work.
Feldman et al.
Page 2
Author Manuscript
(MESA) (2000-2002) 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: coronary artery calcium [CAC], carotid intima-media thickness [cIMT], carotid plaque, ankle-brachial index [ABI]; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow-mediated dilation [FMD]), and ED symptoms at follow-up.
Author Manuscript
Results—Mean baseline age was 59.5±9 years and 839 participants (45%) reported ED symptoms at follow-up. Compared to symptom-free individuals, participants with ED had higher baseline prevalence of CAC>100 (36.4% vs 17.2%), cIMT Z-score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility
Clin Cardiol. Author manuscript; available in PMC 2017 May 03. Published in final edited form as: Clin Cardiol. 2016 May ; 39(5): 291–298. doi:10.1002/clc.22530.
Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multi-Ethnic Study of Atherosclerosis (MESA) David I. Feldman, BS1, Miguel Cainzos-Achirica, MD1,2, Kevin L. Billups, MD1,3, Andrew P. DeFilippis, MD1,4, Kanchan Chitaley, PhD5, Philip Greenland, MD6, James H. Stein, MD7, Matthew J. Budoff, MD8, Zeina Dardari, MSc1, Martin Miner, MD9, Roger S. Blumenthal, MD1, Khurram Nasir, MD, MPH1,10, and Michael J. Blaha, MD, MPH1
Author Manuscript
1Ciccarone
Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, MD
2Welch
Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 3The
James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD
4University
of Louisville, KentuckyOne Health - Jewish Hospital, Louisville, KY
5Department
of Environmental and Occupational Health Sciences, University of Washington,
Seattle, WA 6Departments
Author Manuscript
of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 7Cardiovascular
Medicine Division, University of Wisconsin School of Medicine and Public Health,
Madison, WI 8Department
of Internal Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Torrance,
CA 9Department 10Baptist
of Family Medicine, The Alpert Medical School of Brown University, Providence, RI
Health South Florida, Miami, FL
Abstract
Author Manuscript
Background—To study the association between subclinical vascular disease and subsequent development of erectile dysfunction (ED). Hypothesis—Among a number of subclinical atherosclerosis and vascular dysfunction measurements, the coronary artery calcium (CAC) score is the best predictor of erectile dysfunction. Methods—After excluding participants taking ED medications at baseline, we studied 1,862 men aged 45-84 years free of known CVD from the prospective Multi-Ethnic Study of Atherosclerosis
Corresponding Author: Dr. Michael J. Blaha, MD, MPH, Carnegie 565A – The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, Phone: 443-287-4960, Fax: 410-614-9190, ; Email: [email protected] Disclosures: None of the authors report conflicts of interest pertaining to this work.
Feldman et al.
Page 2
Author Manuscript
(MESA) (2000-2002) 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: coronary artery calcium [CAC], carotid intima-media thickness [cIMT], carotid plaque, ankle-brachial index [ABI]; vascular stiffness/function domain: aortic stiffness, carotid stiffness, brachial flow-mediated dilation [FMD]), and ED symptoms at follow-up.
Author Manuscript
Results—Mean baseline age was 59.5±9 years and 839 participants (45%) reported ED symptoms at follow-up. Compared to symptom-free individuals, participants with ED had higher baseline prevalence of CAC>100 (36.4% vs 17.2%), cIMT Z-score >75th percentile (35.3% vs 16.6%), carotid plaque score ≥2 (39% vs 21.1%), carotid distensibility
