Erectile Dysfunction in Men Burdened with the Familial Occurrence of Coronary Artery Disease.

Dariusz Kałka,Anna Miętka,Marzena Majchrowska,Aneta Mrozek-Szetela,Małgorzata Sobieszczańska,Agnieszka Rusiecka,Małgorzata Biernikiewicz,Ewa Szuster,Jana Gebala,Krystyna Rożek-Piechura

doi:10.3390/jcm10184046

Abstract

Erectile dysfunction (ED) and coronary artery disease (CAD) share common risk factors, some of which have genetic backgrounds, while others may be stimulated by family lifestyle. We investigated the impact of the familial occurrence of CAD on the presence of ED and the presence of classic risk factors for ED in men with CAD. This cross-sectional observational study involved 751 men with CAD who were subjected to cardiac rehabilitation. Overall, 75.63% of the men had ED. CAD was diagnosed in 39.28% of the studied men’s relatives. ED was less frequent in the men with familial CAD than in those without (71.53% vs. 78.29%). Similar relations were observed for the presence of CAD in parents (70.43% vs. 78.34%) and the father (69.95% vs. 77.46%). The International Index of Erectile Function 5 score was significantly higher in patients with familial CAD (median (interquartile range); 17 (12–22) vs. 16 (10–21); p = 0.0118), in parents (18 (12–22) vs. 16 (10–20); p = 0.021), and in the father (18 (12–22) vs. 16 (10–21); p = 0.0499). Age and education minimized the effect of familial CAD. Familial CAD increased the incidence of hypertension, dyslipidemia, and smoking but not sedentary lifestyle. Despite the higher prevalence of selected risk factors for ED in men with familial CAD, a higher incidence of ED was not observed.

Highlights

A family history of coronary artery disease (CAD), a type of cardiovascular disease (CVD), has been thoroughly investigated and confirmed to be an independent risk factor for CAD in future generations [1]
The analysis of the used therapeutic options showed that Erectile dysfunction (ED) occurred significantly more often in patients treated with coronary artery bypass grafts (CABG) (83.76% vs. 70.38%, p < 0.0001), angiotensin II receptor blockers (93.10% vs. 74.17%; p = 0.0021), diuretics (81.95% vs. 72.16%; p = 0.0037), and alfa-blockers (93.94% vs. 74.79%; p = 0.0215)
The analysis of the used treatments shows that a significantly higher score in the Index of Erectile Function 5 (IIEF-5) questionnaire was associated with using angiotensin-converting-enzyme inhibitors (median 17; IQR (12–22) vs. median 15 (10–20); p = 0.0008), while a significantly lower score was associated with a history of CABG (median 15; IQR (9–19) vs. median 18 IQR (12–22), p < 0.0001), and the use of angiotensin II receptor blockers (median 14, IQR (7–17) vs. median 17, IQR (11–22); p = 0.0004), calcium channel blockers (median 15; IQR (9–21) vs. median 17, IQR (11–21); p = 0.0297), diuretics (median 15, IQR (9–20) vs. median 17 (12–22); p = 0.0002), and alfa-blockers (median 13, IQR (10–16) vs. median 16 (11–22); p = 0.0085)

Summary

Introduction

A family history of coronary artery disease (CAD), a type of cardiovascular disease (CVD), has been thoroughly investigated and confirmed to be an independent risk factor for CAD in future generations [1]. Evidence exists that the genes that regulate lipid metabolism, as well as those that control the activity of the renin–angiotensin–aldosterone (RAA) system, contribute to the development of CAD due to their impact on arterial blood pressure [2,3,4]. A negative impact of genetic and environmental factors, which contribute to the pathogenesis of CAD, have a similar effect on the development of the whole spectrum of cardiovascular diseases, including vasculogenic erectile dysfunction (ED) [5,6].

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