Key result
Higher resting heart rate linked to ~72% greater new-onset ED risk in high-risk CV men.
Why the study?
The interaction between high heart rate and systolic blood pressure in the development of erectile dysfunction in high-risk cardiovascular patients remains unclear.
Is high resting heart rate or high systolic blood pressure associated with the development of erectile dysfunction in high-risk cardiovascular male patients?
Cohort (n=1,015)
Yes
Is high resting heart rate or high systolic blood pressure associated with the development of erectile dysfunction in high-risk cardiovascular male patients?
Odds Ratio: 1.72 (95% CI 1.8–2.5)
Absolute Event Rate: 41% vs 29%
p-value: p=0.0047
High resting heart rate, but not high systolic blood pressure, is significantly associated with the development of new-onset erectile dysfunction in men at high cardiovascular risk.
High resting heart rate was associated with new-onset ED; hypothesis-generating and should not yet change practice.
AIMS: Erectile dysfunction (ED) is associated with cardiovascular risk factors as elevated systolic blood pressure (SBP), resting high heart rate (HR), and endothelial dysfunction and predicts cardiovascular events. However, the interaction between high HR and SBP and the development of ED remains unclear. METHODS AND RESULTS: We evaluated 1015 male patients enrolled in the ED substudy of ONTARGET and TRANSCEND, examining the influence of mean HR and mean SBP obtained over all study visits (mean 10.9±1.4 study visits) and their interaction with ED. In patients without pre-existing ED, new onset ED was detected in 29% of patients below, and 41% of patients above, the median of mean HR (OR 1.72, 95% CI 1.8-2.5, p = 0.0047). In patients with pre-existing ED, high HR had no add-on effect. With or without pre-existing ED, high SBP had no influence after adjustment for covariates (OR 1.03, 95% CI 0.66-1.59, p = 0.91). In a continuous model, it was shown that effects of high HR were prominent at low Kölner (Cologne) Evaluation of Erectile Function (KEED) score baseline values and in the presence of SBP above the median. CONCLUSIONS: In patients at risk for cardiovascular events, high HR is associated with ED, whereas the effect of high SBP was not significant. High resting HR might represent a cardiovascular risk indicator. Whether HR represents a potential treatment target to improve ED in high-risk individuals must be scrutinized in prospective trials.
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Kratz et al. (2013) conducted a cohort in High-risk cardiovascular patients (n=1,015). High resting heart rate (above median) vs. Heart rate below median was evaluated on New onset erectile dysfunction (OR 1.72, 95% CI 1.8-2.5, p=0.0047). A resting heart rate above the median was associated with increased new-onset erectile dysfunction compared to below the median in high-risk cardiovascular men (41% vs 29%; OR 1.72, P=0.0047).
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