Prior studies of erectile dysfunction (ED) tend to narrowly focus on relationships with specific comorbidities, rather than evaluating a more comprehensive array of risk factors and assessing naturalistic patterns among them. This study identifies natural clusters of male characteristics from a general population sample per country, quantifies ED dynamics in these profiles, and compares profiles across US, Italy, Brazil, and China samples.
National Health and Wellness Survey 2015 and 2016 patient-reported data on men aged 40-70 years (US n=15,652; Italy n=2,521; Brazil n=2,822; China n=5,553) were analyzed. Hierarchical agglomerative clustering identified clusters where predictors included demographics, health characteristics/behaviors, ED risk factors, and provider visits in the past six months. Multinomial logistic regression assessed the independent utility of variables in predicting cluster membership, compared with the healthiest control cluster per country.
Different natural clusters were found across countries, with four clusters for the US, Italy, and China and three clusters for Brazil. Age, income, employment, health behaviors, and ED risk factors predicted different cluster membership across countries. In the US, Italy, and Brazil, younger clusters were predicted by ED, unhealthy behaviors, and ED risk factors. Unique cluster profiles were identified in China, with ED and ED risk factors (aside from hypertension) not predicting cluster membership, while socio-demographics and health behaviors were strongly predictive.
Natural cluster profiles revealed notable ED rates among adult males of age 40-70 in four different countries. Clusters were mainly predicted by unhealthy behaviors, ED risk factors, and ED, regardless of level or presence of positive health characteristics and behaviors. This analysis identified meaningful subgroups of men with heightened ED risk factors, which can help healthcare providers to better recognize specific populations with the greatest need for intervention. This article is protected by copyright. All rights reserved.
International journal of clinical practice. 2019 May 23 [Epub ahead of print]
Irwin Goldstein, Amir Goren, Ryan Liebert, Wing Yu Tang, Tarek A Hassan
Director of Sexual Medicine, Alvarado Hospital, San Diego, CA, USA., Health Outcomes Practice, Kantar Health, New York, NY, USA., Patient and Health Impact, Health Economics and Outcomes Research, Pfizer Inc., New York, NY, USA., Medical Affairs, Pfizer Inc., New York, NY, USA.