Relationship between treatment of erectile dysfunction and future risk of cardiovascular disease: A nationwide cohort study

Abstract

Aims Erectile dysfunction is associated with increased risk of cardiovascular disease; however, little is known about patients seeking treatment for erectile dysfunction. This study investigated the risk of cardiovascular disease for patients receiving medication for erectile dysfunction. Methods and results This nationwide cohort study included 71,710 men aged 40-80 years receiving their first erectile dysfunction medication from 2000 to 2012. Their adjusted risk of cardiovascular events in time intervals after the first erectile dysfunction medication was compared to the general male population using multivariate Poisson regression models and was expressed as a risk ratio (RR). The risk for overall cardiovascular disease was decreased in the first 3 years: the RR in the first year was 0.92 (95% confidence interval [CI] 0.87-0.97, p = 0.003; incidence: 23.68 per 1000 patient-years), and after 1-3 years the RR was 0.94 (95% CI 0.90-0.97, p = 0.002; incidence: 24.92 per 1000 patient-years). After 3 years, there was no significant difference. The risk of myocardial infarction was decreased in all time intervals: the RR in the first year was 0.60 (95% CI 0.50-0.73, p < 0.001; incidence: 1.82 per 1000 patient-years), after 1-3 years the RR was 0.72 (95% CI 0.63-0.82, p < 0.001; incidence: 2.16 per 1000 patient-years) and after 3 years the RR was 0.80 (95% CI 0.73-0.88, p < 0.001; incidence: 2.25 per 1000 patient-years). The risk of heart failure was decreased in the first 3 years. Conclusion Receiving medication for erectile dysfunction was associated with a decreased risk of myocardial infarction and cardiovascular diseases for the first 3 years.

Combination of QTL and GWAS to uncover the role of phosphodiesterases in ischemic heart disease

“…Several clinical trials have demonstrated the benefits of PDE5 inhibitors in patients with heart failure, while the effect on ischemic heart disease is still uncertain (28). A number of observational studies have reported the protective effect of PDE5 inhibitors on ischemic heart disease (29–31). For example, a nationwide Danish cohort study including 71,710 men found that PDE5 inhibitors use was related to a decreased incidence of MI as compared to the general male population without receiving PDE5 inhibitors (RR=0.74; 95% CI=0.69-0.79), however indication bias may play a role in the observed association (31).…”

Endothelial Dysfunction, Erectile Deficit and Cardiovascular Disease: An Overview of the Pathogenetic Links

“…As already stated, ED is supposed to precede CVDs onset by roughly 3 years, giving us the opportunity to properly screen or treat our patients before any major cardiac event takes place. In fact, it was demonstrated by Vastergaard et al that men with no overt prior CVD and that received treatment for ED showed a decreased risk for acute myocardial infarction compared to the general male population, especially in the first year after the start of treatment for ED [ 53 ]. The risk of heart failure slightly decreased in the 3 years after initiation of ED medication as well; however, no significant difference was evidenced regarding stroke incidence.…”

Does erectile dysfunction independently predict cardiovascular events? It’s time to act on the evidence

“…Indeed, the importance of this study is that people can work together to improve the health and quality of life for individuals, families and communities by moving, in our country, from a mindset focused on sickness and disease to one based on prevention and wellness. Vestergaard et al 14 revealed that proper medical intervention of erectile dysfunction was associated with a decreased risk of CVD; and the beneficial efficacy was most obvious in the first year after onset of treatment for erectile dysfunction. Compostella et al 15 suggested that erectile dysfunction still served as a predictor of deterioration of physical performance in patients with CHD or after an acute myocardial infarction.…”

“…Vestergaard et al. 14 revealed that proper medical intervention of erectile dysfunction was associated with a decreased risk of CVD; and the beneficial efficacy was most obvious in the first year after onset of treatment for erectile dysfunction. Compostella et al.…”