Male sexuality and cardiovascular risk: a cohort study in patients with erectile dysfunction
Giovanni Corona1,4, Matteo Monami2, Michela Cameron-Smith1, Francesco Lotti1, Giulia de Vita1, Ceclilia Melani3, Daniela Balzi3, Alessandra Sforza4, Gianni Forti1, Edoardo Mannucci2 & Mario Maggi1
Introduction: No study has ever assessed the possible association of penile blood flow (PBF) and the relational component of sexual function with incident major cardiovascular events (MACE). The aim of this study is to investigate whether severity of erectile dysfunction (ED), PBF and other factors related to a couples relationship predict incident (MACE).
Methods: A subset of 1687 patients was longitudinal studied. Different clinical, biochemical and instrumental (penile flow at color doppler ultrasound: PCDU) parameters were evaluated. Information on MACE was obtained through the City of Florence Registry Office.
Results: During a mean follow-up of 4.3±2.6 years, 139 MACE, 15 of which were fatal, were observed. Cox regression analysis, after adjustment for age and Chronic disease ccore, showed that severe ED predicted MACE (hazard ratio (HR) 1.75; 95% confidence interval (CI) 1.10 to 2.78; P<0.05). In addition, lower PBF, evaluated both in flaccid (before) and dynamic (after PGE1 stimulation) conditions, was associated with an increased risk of MACE (HR=2.67 (1.425.04) and 1.57 (1.012.47) respectively for flaccid (< 13 cm/s) and dynamic (< 25 cm/s) peak systolic velocity; both P<0.05). Perceived partners hypoactive sexual desire (HSD) proved to have a negative and independent effect against MACE. A longer and hostile coupler relationship, as well as stressful job and both alcohol and smoking abuse were significantly associated with perceived womens HSD. In addition, the perceived womens HSD was significantly associated with a stepwise increase of free-floating anxiety and depressive symptoms (adj r=0.081, P<0.05 and 0.158, P<0.0001 respectively).
Conclusions: The investigation of male sexuality could provide insights not only into present cardiovascular status but also into prospective risk. Perceived womens sexual interest (éros) can bee seen for men not only as an enjoyable behavior, but also a safe strategy for improving mens overall health and life expectancy.