Get access

Cardiovascular Mortality in Men with Erectile Dysfunction: Increased Risk But Not Inevitable

Authors

  • Kew-Kim Chew MBBS, PhD, FRCPEdin, FRCPGlasg,

    Corresponding author
    1. Keogh Institute for Medical Research, Nedlands, Perth, Australia
      Kew-Kim Chew, MBBS, PhD, FRCPEdin, FRCPGlasg, Keogh Institute for Medical Research- Nedlands, Perth, Western Australia 6009, Australia. Tel: +618 93462008; Fax: +618 93898384; E-mail: kewkimchew@hotmail.com
    Search for more papers by this author
  • Nicholas Gibson RN, BAppSci, PGradHlthAdmin, PhD, FRCNA,

    1. School of Primary, Aboriginal and Rural Health, University of Western Australia, Nedlands, Perth, Australia
    Search for more papers by this author
  • Frank Sanfilippo BSc, BPharm, PGradDipPharm, FPS, PhD,

    1. School of Population Health, University of Western Australia, Nedlands, Perth, Australia
    Search for more papers by this author
  • Bronwyn Stuckey MBBS, FRACP,

    1. Keogh Institute for Medical Research, Nedlands, Perth, Australia
    2. School of Medicine and Pharmacology, University of Western Australia, Nedlands, Perth, Australia
    3. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
    Search for more papers by this author
  • Alexandra Bremner BSc(Hons), GradDipAppStats, PhD

    1. School of Population Health, University of Western Australia, Nedlands, Perth, Australia
    Search for more papers by this author

Kew-Kim Chew, MBBS, PhD, FRCPEdin, FRCPGlasg, Keogh Institute for Medical Research- Nedlands, Perth, Western Australia 6009, Australia. Tel: +618 93462008; Fax: +618 93898384; E-mail: kewkimchew@hotmail.com

ABSTRACT

Introduction.  It is unclear whether men with erectile dysfunction (ED) ultimately die of cardiovascular (CV) causes.

Aim.  This study examined the causes of death in men with ED and their risk of CV death.

Methods.  Based on statutory death registrations and hospital morbidity data, the risk of CV death in men with ED in a linked-data study was assessed against the CV mortality risk in a reference male population.

Main Outcome Measures.  Deaths from CV causes as proportions of all deaths. Age-specific rate, mortality rate ratio (MRR), standardized mortality rate ratio (SMRR), and adjusted hazard ratio (HR).

Results.  CV mortality was 4.0%. Compared with the reference population, the risk of CV death was higher in men with ED (SMRR 2.2; 95% confidence interval [CI] 1.6, 3.0). Risk of CV mortality was higher in men with CV disease prior to ED (adjusted HR 1.7; 95% CI 1.1, 2.6) or with history of hospital admissions for CV events (adjusted HR 2.2; 95% CI 1.3, 3.8), compared with those without the respective history. MRR was significantly increased in the 40–69 years age group (MRR 4.1; 95% CI 3.2, 5.2). The median time interval between manifestation of ED and CV death was 10.0 years. A greater proportion of deaths from oncological than from CV causes (25.0% vs. 10.8%) occurred within the first 5 years of the manifestation of ED.

Conclusions.  Although the risk of CV mortality is greater in men with ED, almost as many men die of oncological as of CV causes, with a higher proportion of oncological deaths occurring sooner subsequent to the first manifestation of ED. Chew K-K, Gibson N, Sanfilippo F, Stuckey B, and Bremner A. Cardiovascular mortality in men with erectile dysfunction: Increased risk but not inevitable. J Sex Med 2011;8:1761–1771.

Get access to the full text of this article

Ancillary