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• W2212034679 abstract "No AccessJournal of UrologyAdult Urology1 Apr 2016Erectile Dysfunction is Predictive of Endothelial Dysfunction in a Well Visit Population Charles C. Peyton, Marc A. Colaco, Robert Caleb Kovell, Jung H. Kim, and Ryan P. Terlecki Charles C. PeytonCharles C. Peyton Department of Urology, Winston Salem, North Carolina More articles by this author , Marc A. ColacoMarc A. Colaco Department of Urology, Winston Salem, North Carolina More articles by this author , Robert Caleb KovellRobert Caleb Kovell Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author , Jung H. KimJung H. Kim Wake Forest School of Medicine, Winston Salem, North Carolina More articles by this author , and Ryan P. TerleckiRyan P. Terlecki Department of Urology, Winston Salem, North Carolina More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.11.037AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The relationship between erectile dysfunction and endothelial dysfunction has been described and is associated with adverse cardiac events. Endothelial dysfunction is believed to precede erectile dysfunction. Our objective was to characterize the prevalence of subjective erectile dysfunction, endothelial dysfunction and commonly related comorbidities in a population of men undergoing wellness screening. Materials and Methods: A total of 205 men presented for wellness screening. They underwent testing for endothelial dysfunction via peripheral arterial tonometry and completed a health screening questionnaire. Reactive hyperemia index scores were generated by peripheral arterial tonometry testing. A reactive hyperemia index score of 1.67 or less defined endothelial dysfunction. The Student t-test and Fisher exact test were performed for continuous and categorical variables, respectively. The association of endothelial dysfunction, erectile dysfunction and various comorbidities was calculated using univariate and multivariable analyses. Results: Of 205 men 47 reported subjective erectile dysfunction. Median age was 44 years old. The mean reactive hyperemia index in patients with erectile dysfunction was significantly lower than in patients without erectile dysfunction (1.63 vs 1.87, p = 0.001). Endothelial dysfunction was more common in men with than without erectile dysfunction (55% vs 36%, p = 0.027). Multivariable analysis revealed that men with erectile dysfunction and obesity were twofold more likely to have concomitant endothelial dysfunction (OR 2.45, 95% CI 1.13–4.24, p = 0.02 and OR 2.08, 95% CI 1.16–3.75, p = 0.01, respectively). Conclusions: Among middle-aged men presenting for wellness screening erectile dysfunction and obesity independently predicted endothelial dysfunction, a known risk factor for long-term adverse cardiac events. References 1 : Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol1994; 151: 54. Link, Google Scholar 2 : Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J2006; 27: 2632. Google Scholar 3 : Erectile dysfunction and subsequent cardiovascular disease. JAMA2005; 294: 2996. Google Scholar 4 : Inflammation, metabolic syndrome, erectile dysfunction, and coronary artery disease: common links. Eur Urol2007; 52: 1590. Google Scholar 5 : Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. Int J Androl2012; 35: 636. Google Scholar 6 : Impaired elasticity of aorta in patients with erectile dysfunction. Urology2007; 70: 558. Google Scholar 7 : Erectile dysfunction predicts generalised cardiovascular disease: evidence from a case-control study. Atherosclerosis2007; 194: 458. Google Scholar 8 : The triad: erectile dysfunction—endothelial dysfunction—cardiovascular disease. Curr Pharm Des2008; 14: 3700. Google Scholar 9 : Association of peripheral microvascular dysfunction and erectile dysfunction. J Urol2015; 193: 612. Link, Google Scholar 10 : The assessment of endothelial function: from research into clinical practice. Circulation2012; 126: 753. Google Scholar 11 : Penile and systemic endothelial function in men with and without erectile dysfunction. Eur Urol2009; 55: 979. Google Scholar 12 : Endothelial function in patients with vasculogenic erectile dysfunction. Int J Cardiol2005; 103: 19. Google Scholar 13 Itamar Medical. Available at http://www.itamar-medical.com/EndoPAT.html. Accessed March 29, 2015. Google Scholar 14 : Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. Eur Heart J2010; 31: 1142. Google Scholar 15 : Enhanced external counterpulsation improves endothelial function in patients with symptomatic coronary artery disease. J Am Coll Cardiol2003; 41: 1761. Google Scholar 16 : Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol2004; 44: 2137. Google Scholar 17 : Assessment of EndoPAT scores in men with vasculogenic and non-vasculogenic erectile dysfunction. Int J Clin Pract2013; 67: 46. Google Scholar 18 : Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction. Int J Impot Res2014; 26: 218. Google Scholar 19 : Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study. Circulation2008; 117: 2467. Google Scholar 20 : The temporal relationship between erectile dysfunction and cardiovascular disease. Int J Clin Pract2007; 61: 2019. Google Scholar 21 : The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med2006; 3: 28. Google Scholar 22 : The application of digital pulse amplitude tonometry to the diagnostic investigation of endothelial dysfunction in men with erectile dysfunction. Andrologia2011; 43: 9. Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySeftel A (2017) Re: Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (MESA)Journal of Urology, VOL. 198, NO. 2, (236-237), Online publication date: 1-Aug-2017.Seftel A (2017) Re: Association between Treatment for Erectile Dysfunction and Death or Cardiovascular Outcomes after Myocardial InfarctionJournal of Urology, VOL. 198, NO. 2, (236-238), Online publication date: 1-Aug-2017.Seftel A (2016) Re: Vascular and Chronological Age in Men with Erectile Dysfunction: A Longitudinal StudyJournal of Urology, VOL. 196, NO. 3, (857-858), Online publication date: 1-Sep-2016. Volume 195Issue 4 Part 1April 2016Page: 1045-1050 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsendotheliumobesityhyperemiapeniserectile dysfunctionMetricsAuthor Information Charles C. Peyton Department of Urology, Winston Salem, North Carolina More articles by this author Marc A. Colaco Department of Urology, Winston Salem, North Carolina More articles by this author Robert Caleb Kovell Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania More articles by this author Jung H. Kim Wake Forest School of Medicine, Winston Salem, North Carolina More articles by this author Ryan P. Terlecki Department of Urology, Winston Salem, North Carolina More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2212034679 title "Erectile Dysfunction is Predictive of Endothelial Dysfunction in a Well Visit Population" @default.
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