Erectile Dysfunction Is Not Independently Associated with Cardiovascular Death: Data from the Vitamins and Lifestyle (VITAL) Study
Erectile Dysfunction Is Not Independently Associated with Cardiovascular Death: Data from the Vitamins and Lifestyle (VITAL) Study
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DOI：
10.1111/j.1743-6109.2012.02826.x
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发表时间：
2012-08-01
影响因子：
3.5
通讯作者：
White, Emily
中科院分区：
文献类型：
--
作者：
Hotaling, James M.;Walsh, Thomas J.;White, Emily
介绍。勃起功能障碍（ED）是老年男性的一个严重问题。 ED 与心血管 (CV) 事件（心绞痛、心肌梗死和中风）独立相关。目的。我们试图确定 ED 是否与心血管死亡相关。主要成果措施。患有 ED 的男性有心血管死亡的风险。方法。 2000-2002 年，华盛顿州的 31,296 名 5076 岁男性完成了一份关于补充剂、饮食、运动、个人健康和 ED 的调查问卷。 ED 由一个问题决定：您去年是否经历过阳痿？我们排除了有冠状动脉疾病或中风病史的患者。 2008 年，参与者每年都会与华盛顿州死亡证明系统建立联系。 CV 死亡是通过列出 CV 相关死亡的死亡证明来定义的（国际疾病分类第十版修订版 [ICD-10] 代码：I00-I15、I20-I52 和 I60-I99）。我们对年龄、婚姻状况、种族、教育、健康自评、体重指数 (BMI)、抗高血压/降脂药物使用、糖尿病、心血管疾病家族史、吸烟和运动进行了多变量 Cox 比例风险回归调整。结果。大约 7,762 名男性患有 ED，在 7.8 年的平均随访期间，有 486 人因心血管疾病死亡。死于心血管疾病的典型男性年龄较大、单身、健康状况不佳、服用抗高血压药物、体重指数较高、吸烟者、糖尿病患者，并且有心血管疾病家族史。仅调整年龄、婚姻状况和教育程度时，患有 ED 的男性心血管死亡风险增加 23%（风险比 [HR] 1.23，95% 置信区间 [CI] 1.01、1.49）。进一步调整已知的心血管疾病危险因素（糖尿病、高血压或高脂血症的治疗、心肌梗塞/中风家族史、BMI和运动），ED不再预测心血管死亡（HR 0.93，95% CI 0.76，1.15）。结论。在这个基于社区的队列中，ED 与心血管死亡风险升高并不独立相关。这些数据与先前将 ED 和 CV 事件相关联的数据并不矛盾，而是表明 ED 可能是其他已知的 CV 疾病危险因素的表现。 Hotaling JM、Walsh TJ、Macleod LC、Heckbert S、Pocobelli G、Wesssels H 和 White E。勃起功能障碍与心血管死亡并不独立相关：来自维生素和生活方式 (VITAL) 研究的数据。 《性医学杂志》2012；9：21042110。
Introduction. Erectile dysfunction (ED) is a significant problem among aging men. ED is independently associated with cardiovascular (CV) events (angina, myocardial infarction, and stroke). Aim. We sought to determine if ED was associated with CV death. Main Outcome Measures. Risk of CV death in men with ED. Methods. Exactly 31,296 men in Washington aged 5076 completed a questionnaire in 20002002 on supplements, diet, exercise, personal health, and ED. ED was determined by one question: Have you experienced impotence in the last year? We excluded patients with a history of coronary artery disease or stroke. Participants linked yearly through 2008 to the Washington State Death Certificate System. CV death was defined by death certificates listing CV-related deaths (International Classification of Diseases 10th Revision [ICD-10] codes: I00-I15, I20-I52, and I60-I99). We performed multivariate Cox proportional hazard regression adjusting for age, marital status, race, education, self-rating of health, body mass index (BMI), antihypertensive/lipid-lowering drug use, diabetes, family history of CV disease, smoking, and exercise. Results. About 7,762 men had ED and there were 486 CV deaths over 7.8-year average follow-up. The typical man who suffered CV death was older, single, reporting poor health, taking antihypertensives, higher BMI, a smoker, a diabetic, and had a family history of CV disease. When adjusting for age, marital status, and education only, men with ED had a 23% increased risk of CV death (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.01, 1.49). With further adjustment for known risk factors for CV disease (diabetes, treatment for hypertension or hyperlipidemia, family history of myocardial infarction/stroke, BMI, and exercise), ED no longer predicted CV death (HR 0.93, 95% CI 0.76, 1.15). Conclusions. In this community-based cohort, ED was not independently associated with an elevated risk of CV death. These data do not contradict prior data associating ED and CV events but rather suggest that ED may be a manifestation of other known risk factors for CV disease. Hotaling JM, Walsh TJ, Macleod LC, Heckbert S, Pocobelli G, Wessells H, and White E. Erectile dysfunction is not independently associated with cardiovascular death: Data from the Vitamins and Lifestyle (VITAL) study. J Sex Med 2012;9:21042110.