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Relationship Between Erectile Dysfunction and Silent Myocardial Ischemia in Type 2 Diabetic Patients with No Known Macrovascular Complications

Authors

  • Katherine García-Malpartida MD,

    1. Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain
    2. Research Foundation, Hospital Universitario Dr. Peset, Valencia, Spain
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  • Rosario Mármol MD,

    1. Department of Cardiology, Hospital Universitario Dr. Peset, Valencia, Spain
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  • Ana Jover MD,

    1. Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain
    2. Research Foundation, Hospital Universitario Dr. Peset, Valencia, Spain
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  • Manuel J. Gómez-Martínez MD,

    1. Department of Cardiology, Hospital Universitario Dr. Peset, Valencia, Spain
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  • Eva Solá-Izquierdo MD, PhD,

    1. Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain
    2. Department of Medicine, University of Valencia, Valencia, Spain
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  • Victor M. Victor PhD,

    1. Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain
    2. Research Foundation, Hospital Universitario Dr. Peset, Valencia, Spain
    3. Department of Pharmacology and Ciberehd, University of Valencia, Valencia, Spain
    4. Department of Physiology, University of Valencia, Valencia, Spain
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  • Milagros Rocha PhD,

    1. Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain
    2. Research Foundation, Hospital Universitario Dr. Peset, Valencia, Spain
    3. Department of Pharmacology and Ciberehd, University of Valencia, Valencia, Spain
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  • Darío Sanmiguel MD,

    1. Department of Cardiology, Hospital Universitario Dr. Peset, Valencia, Spain
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  • Antonio Hernández-Mijares MD, PhD

    Corresponding author
    1. Department of Endocrinology, Hospital Universitario Dr. Peset, Valencia, Spain
    2. Department of Medicine, University of Valencia, Valencia, Spain
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  • [Correction added after online publication 23-Jun-2011: Author names have been corrected.]

Prof. Antonio Hernandez-Mijares, MD, PhD, Hospital Doctor Peset, Avda Gaspar Aguilar 90, 46017, Valencia, Spain. Tel: (34) 961622463; Fax: (34) 961622492; E-mail: hernandez_antmij@gva.es

ABSTRACT

Introduction.  Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) because it is highly prevalent among those with cardiovascular risk factors (CVRFs). Moreover, it precedes the development of CVD and is considered a subrogate marker of subclinical CVD.

Aim.  The aim of this study was to evaluate the presence of ED among patients with type 2 diabetes (DM2) without macroangiopathy, and to assess the association between ED and other CVRFs, chronic diabetes complications, silent myocardial ischemia (SMI), and peripheral arterial disease (PAD).

Methods.  One hundred fifty-four male patients with DM2 and without clinical evidence of CVD were included in the study. The presence of ED, PAD, SMI, chronic diabetic complications, and other CVRFs was evaluated in these patients.

Main Outcome Measures.  PAD; SMI; ED; 24-hour blood pressure Holter; lipid profile; insulin resistance; testosterone; chronic inflammation; nephropathy; retinopathy; neuropathy.

Results.  Prevalence of ED was 68.2%. Patients with ED were older and characterized by DM2, systolic blood pressure (BP), retinopathy, and insulin treatment of longer duration than patients without ED, even when adjusting for age was performed. Adjusting for duration of diabetic condition revealed significant differences in age and systolic BP. Independent factors for ED were age (57.7 ± 7.5 years, relative risks [RR 1.1], P = 0.003) and duration of diabetes (9[3–15] years, RR 1.1, P = 0.006). SMI was detected in 13.6% of patients (18.1% in patients with ED vs. 4.1% in patients without ED). Asymptomatic PAD was detected in 13.2% of subjects (14.4% in patients with ED vs. 10.4% in patients without).

Conclusions.  ED is highly prevalent in DM2, and is associated with the presence of SMI, higher systolic BP and chronic microvascular diabetic complications. García-Malpartida K, Mármol R, Jover A, Gómez-Martínez MJ, Solá-Izquierdo E, Victor VM, Rocha M, Sanmiguel D, and Hernández-Mijares A. Relationship between erectile dysfunction and silent myocardial ischemia in type 2 diabetic patients with no known macrovascular complications. J Sex Med 2011;8:2606–2616.

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