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25-09-2011 | Cardiology | Article

Reduction in CV risk factors improves sexual function in men with ED


Free abstract

MedWire News: US researchers report further evidence supporting lifestyle intervention and cardiovascular (CV) risk reduction as methods to improve sexual function in men with erectile dysfunction (ED).

ED is known to share certain modifiable risk factors with the CV diseases atherosclerosis and coronary artery disease, including hypertension, diabetes, dyslipidemia, cigarette smoking, obesity, metabolic syndrome, and sedentary behavior.

The results of the current meta-analysis, reported in the Archives of Internal Medicine, show that healthy dietary habits, increased physical activity, and pharmacotherapy that targets CV risk factors can all significantly improve erectile function in men with ED.

However: "Increased awareness of ED association with coronary risk factors may provide an opportunity for early identification of risk factors modifiable with lifestyle interventions and thus avoid adverse effects of pharmacologic therapy," write Bhanu Gupta and colleagues from the Mayo Clinic in Rochester, Minnesota.

The team reviewed six trials that involved at least 6 weeks of lifestyle modification (four studies) or pharmacotherapy (two studies) for CV risk factors, and measured ED according to the International Index of Erectile Dysfunction (IIEF-5) questionnaire.

Trials were published between 2004 and 2010 and included a total of 740 participants, of whom 374 were assigned to intervention arms and 366 to control arms for a range of 12 to 104 weeks follow-up.

The researchers calculated the weighted mean difference in IIEF-5 scores for each study, where the maximum score is 25 points, and high scores denote normal functioning (mild-severe ED=12-≤7 points).

Results of the pooled analysis revealed a statistically significant improvement in IIEF-5 score overall; with a weighted mean difference of 2.66.

For trials that only assessed lifestyle modifications' effect on ED, the improvement in sexual function remained significant (weighted mean difference=2.40), and the same trend was seen in trials involving pharmacotherapy (weighted mean difference=3.07).

The team remarks that despite the acknowledged minimal clinically important difference (MCID) in IIEF-5 score being a 4-point improvement, the severity of ED function at baseline can have an impact, so that a two-point improvement in mild ED cases represents a MCID.

"Sexual health is an important indicator of quality of life for men, and decrease in sexual function may be an early manifestation of developing components of CV risk factors," say Gupta and co-workers.

They add that patients with ED "provide an opportunity" to screen for these risk factors.

Commenting on the research, editorialists Militza Moreno and Thomas Pearson, from the University of Rochester in New York, USA, say that the despite the "persuasive" and "meaningful" benefits of healthy lifestyle on CV disease and ED, "cardiac risk factors are still rampant."

They conclude that, "clinicians and public health practitioners should be reassured that the benefits of their lifestyle modification efforts are overwhelmingly positive and continue to grow, and we should renew our efforts to help patients add life to the years, as well as years to life."

By Sarah Guy

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