Eighteen million American men — nearly one in five, age 20 and older — have erectile dysfunction (ED) and are at greater risk of heart disease, researchers said today at the American Heart Association’s 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
“We found a link between cardiovascular risk factors and ED – which may motivate men to make healthy lifestyle changes,” said Elizabeth Selvin, Ph.D., M.P.H., lead author of the study and a research fellow atJohns Hopkins Bloomberg School of Public Health in Baltimore, Md.
“Lifestyle changes, especially increasing exercise level, may prevent ED,” she said. “The associations between ED and diabetes and other known cardiovascular risk factors should serve as powerful motivators for male patients for whom diet and lifestyle changes are needed to improve their cardiovascular risk profile.”
She said the data suggest physical activity and other measures that prevent cardiovascular disease and diabetes also may prevent or decrease ED. Furthermore, the high prevalence of diabetes and high blood pressure in men with ED suggests that physicians should screen patients reporting ED for these risk factors.
Researchers reviewed data from 2,216 adult male participants in the 2001-02 National Health and Nutrition Examination Survey (NHANES) — data representative of the noninstitutionalized U.S. adult male population.
When asked about their “ability to get and keep an erection adequate for satisfactory intercourse,” men responded with “always,” “usually,” “sometimes” or “never.” In this study, ED was defined as “sometimes able” or “never able” to get and keep an erection. Men who reported being “always or almost always able” or “usually able” to get and keep an erection were categorized as not having ED.
The overall prevalence of ED in the general U.S. male population age 20 years and older was 18.4 percent. Applying this value to the 2000 U.S. Census population age 20 and older suggests 18 million men in the country have ED, Selvin said.
She said the self-reported data is reliable. “Self-report is the way ED is evaluated and diagnosed in a clinical setting. Furthermore, widespread awareness of the issue during the time of the survey (1999-2000) may have resulted in more accurate reporting of the condition compared with previous surveys.”
Among other significant findings:
The prevalence of ED differed markedly by age, ranging from 5 percent in men age 20 to 40 and up to 70 percent in men age 70 and older.
One or more cardiovascular risk factors, including high blood pressure, diabetes and physical inactivity, are also risk factors for ED.
ED affects more than half of all men (aged 20 and over) in the country with diabetes.
Men with diabetes were 3 times more likely to have ED compared with men without diabetes, even after accounting for other risk factors.
Physical inactivity and sedentary behaviors such as TV watching were strongly associated with ED.
“The availability of effective drugs has revolutionized the management of erectile dysfunction, but the burden of the condition in the general adult male population was previously unknown. Our study assessed the prevalence of ED in the general U.S. adult male population, the prevalence of cardiovascular disease risk factors among men with ED, and the associations between cardiovascular risk factors and ED, including physical activity,” she said.
“With the advent of ED treatment, physicians should be aggressive in screening for and managing their middle-aged and older patients with this important quality-of-life issue,” Selvin said.
Co-authors are Arthur L. Burnett, M.D., and Elizabeth A. Platz, Sc.D., M.P.H.
