Significant evidence exists linking the relationship between erectile dysfunction (ED) and the development of cardiovascular disease (CVD). Moreover, ED has been shown to predict atherosclerotic cardiovascular events even in men even without symptomatic CVD (mortality hazard ratio = 1.43).
A recent cohort study of 2,318 Australian men sought to examine causes of death in men with ED, as well as their overall risk of death due to CVD. Overall cardiovascular mortality in this study was 4%. While the risk of mortality due to CVD was higher in men with diagnosed CVD prior to the diagnosis of ED, the median time interval between manifestation of ED and CV death was 10 years, predominantly in the 40-69 age group.
The relative risk of mortality from CVD was highest in men with ED with a history of hospital admission for cardiovascular events. This finding implies a significant increase in the risk of CVD in men subsequent to the development of symptoms of ED. Despite a statistically significant increase in the risk of cardiovascular mortality, the study revealed that only 35% of deaths in men with ED were related to cardiovascular etiologies, while 65% were from non-cardiovascular causes (deaths from cancer approached 29%). The authors admit a potential limitation of their study centered on a small bias in that the medical records may have indicated a cardiovascular morbidity in some men who died from either CVD or cancer, yet this bias is thought to essentially be insignificant, and would not necessarily affect the median time interval between ED and CVD mortality.
Reference: Chew K-K, Gibson N, Sanfilippo F, et al. Cardiovascular mortality in men with erectile dysfunction: increased risk but not inevitable. J Sex Med 2011;8:1761-71.