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Erectile Dysfunction Predicts Death in High-Risk Patients

In men with cardiovascular disease, those with ED have a doubled risk of all-cause mortality

TUESDAY, March 16 (HealthDay News) -- In men with cardiovascular disease, erectile dysfunction (ED) is a strong predictor of death, heart attack, stroke, and heart failure, according to a study published online March 15 in Circulation.

Michael Böhm, M.D., of the University of the Saarland in Saarbrücken, Germany, and colleagues conducted a sub-study of 1,519 men enrolled in the ONTARGET and TRANSCEND trials. In ONTARGET, patients were randomly assigned to receive ramipril, or telmisartan, or ramipril and telmisartan. In TRANSCEND, angiotensin converting enzyme inhibitor-intolerant patients were randomly assigned to receive either telmisartan or placebo.

Compared to subjects without ED, the researchers found that those with ED had an increased risk of all-cause death (hazard ratio, 1.84) and the composite primary outcome (hazard ratio, 1.42), which consisted of cardiovascular death, myocardial infarction, hospitalization for heart failure, and stroke (hazard ratios, 1.93, 2.02, 1.2, and 1.1, respectively).

"Proven risk-reducing medications such as ramipril, telmisartan, and the combination thereof did not have different effects on ED, but neither treatment adversely affected erectile function," the authors conclude. "The evaluation of ED in the medical history as an early symptom of endothelial dysfunction and atherosclerosis and as a predictor of death and future cardiovascular events might be relevant to identify patients at particularly high risk of experiencing a cardiovascular event."

The ONTARGET/TRANSCEND studies were supported by Boehringer-Ingelheim; all of the authors reported financial relationships with the company.

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