Erectile dysfunction: A hidden epidemic

Abstract

Erectile dysfunction is commonly faced by men with cardiovascular disease. We aimed to determine the prevalence of erectile dysfunction in patients with cardiovascular disease risk factors in Singapore. We conducted a cross-sectional survey on patients with cardiovascular disease risk factors from June 2014 to July 2014 at the outpatient cardiology clinics of our tertiary institution. The survey included patient demographics, comorbidities and an abridged version of the International Index of Erectile Function (IIEF-5). Erectile dysfunction severity was categorized as absent (IIEF-5 score: 22-25), mild (IIEF-5 score: 17-21), moderate (IIEF-5 score: 8-16) and severe (IIEF-5 score: <8). Independent variables were demographic factors (i.e. age, race, occupation, etc.) and comorbidities (i.e. diabetes, hypertension, etc.). Primary dependent variable was the presence of erectile dysfunction and secondary dependent variable was the severity of erectile dysfunction. A total of 468 male respondents (mean age 57±11.2 years) were included. Sixty-nine per cent of respondents reported the presence of erectile dysfunction, with further breakdown into 29% with mild, 30% with moderate and 10% with severe erectile dysfunction. Multivariate analysis revealed that significant predictive risk factors of erectile dysfunction were old age (odds ratio (OR) 1.073, 95% confidence interval (CI) 1.050-1.097, p<0.001), the presence of diabetes (OR 2.127, 95% CI 1.186-3.81, p=0.001) and a lower level of education (OR 2.392, 95% CI 1.387-4.125, p=0.002). These three factors were significant predictors for severity of erectile dysfunction (p-values of 0.000). Prevalence of erectile dysfunction is high in patients with cardiovascular disease risk factors. Cardiologists should screen for erectile dysfunction particularly in patients with older age, diabetes and lower education levels.