Although erectile dysfunction (ED) is considered a well-established risk factor for
cardiovascular disease (CVD), few studies have investigated whether other aspects
of sexual function might predict CVD independently of ED. In a longitudinal, population-based
study of community-dwelling men participating in the Massachusetts Male Aging Study,
we examined sexual function variables (including ED) and the subsequent development
of CVD. ED was defined according to a validated, discriminant-analytic formula determined
from the questionnaire responses and categorized as moderate/complete ED versus none/minimal.
CVD included a wide range of major end points and was ascertained through self-report,
medical records, and the National Death Index. We calculated the age-adjusted incidence
rates according to the person-years of follow-up, and Cox proportional hazards models
were used to estimate covariate-adjusted, Framingham risk score-adjusted, and ED-adjusted
hazard ratios and 95% confidence intervals for sexual function variables and the subsequent
risk of CVD. Of the 1,165 men free of CVD at baseline, the age-adjusted CVD incidence
rate for moderate/complete ED and none/minimal ED was 17.9/1,000 person-years and
12.5/1,000 person-years, respectively. In multivariate models adjusted for age, covariates,
ED, and the Framingham risk score, a low frequency of sexual activity (once a month
or less vs ≥2 times weekly) was associated with increased risk of CVD (hazard ratio
1.45, 95% confidence interval 1.04 to 2.01). In conclusion, our results suggest that
a low frequency of sexual activity predicts CVD independently of ED and that screening
for sexual activity might be clinically useful.
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Article Info
Publication History
Accepted:
August 25,
2009
Received in revised form:
August 25,
2009
Received:
June 30,
2009
Footnotes
The Massachusetts Male Aging Study was supported by grant AG04763 from the National Institute on Aging and grants DK51345 and DK44995 from the National Institute of Diabetes and Digestive and Kidney Diseases (Bethesda, MD). Additional support for these analyses was provided by Eli Lilly and Company (Indianapolis, Indiana).
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© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
