PURPOSE: Increasing evidence of a link between erectile dysfunction (ED) and cardiovascular disease (CVD) suggests a shared vascular etiology with endothelial dysfunction as a plausible underlying biological mechanism.
Whether this association is different for large arterial compared to microvascular endothelium has yet to be established. The objective of this study was to investigate the association of ED with macrovascular and microvascular endothelial function.
MATERIALS AND METHODS: A sample of 390 men (mean age 55.5 years) was recruited from the Boston Area Community Health (BACH) Survey, a population-based survey of urologic symptoms. ED was assessed using the 5-item International Index of Erectile Function (IIEF-5). Brachial artery flow-mediated dilation (FMD) (%), a measure of macrovascular function, and hyperemic flow velocity (cm/s), a measure of microvascular function, were assessed by ultrasound. Linear regression was used to assess the association of ED and endothelial function and adjust for potential confounders.
RESULTS: Reactive hyperemia was lower in men with ED (mean (SE) of 97.1(2.5) cm/s) compared to those without ED (106.0(1.6) cm/s, p=0.003). However, the difference in FMD between men with and without ED was statistically non-sginficant (6.6(0.33) vs. 7.2(0.24), p=0.147). The ED and reactive hyperemia association was attenuated but remained statistically significant for men with moderate to severe ED (IIEF-5< 12) after adjusting for traditional cardiovascular risk factors (p=0.038).
CONCLUSIONS: These results provide evidence of microvascular more than macrovascular endothelial dysfunction as a potential contributor to the development of ED and as an underlying mechanism linking ED and cariovascular disease.
Written by:
Gerber RE, Vita JA, Ganz P, Wager CG, Araujo AB, Rosen RC, Kupelian V. Are you the author?
New England Research Institutes, Inc., Watertown, MA; Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University, Boston, MA; Division of Cardiology, San Francisco General Hospital, University of California San Francisco, San Francisco, CA.
Reference: J Urol. 2014 Sep 4. pii: S0022-5347(14)04363-8.
doi: 10.1016/j.juro.2014.08.108
PubMed Abstract
PMID: 25196657