Erectile dysfunction increases atrial fibrillation risk in elderly

USA: Older men with erectile dysfunction (ED) are at increased risk of incident atrial fibrillation (AF) -- abnormal heart rhythm, a recent study published in the American Journal of Medicine has found.

Erectile dysfunction, or impotence, is the inability to achieve and sustain an erection suitable for sexual intercourse. It is estimated that erectile dysfunction affects about 1 in 10 adult males on a long-term basis. A much more common problem that affects most men at some point is the occasional failure to achieve an erection.

Previous cross-sectional studies have demonstrated an association between erectile dysfunction and atrial fibrillation, but the association of erectile dysfunction with incident atrial fibrillation is less well established. Philip Greenland, Feinberg School of Medicine, Northwestern University, and colleagues determined whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors.

The researchers examined a total of 1,760 males from the Multi-Ethnic Study of Atherosclerosis (MESA) who completed self-reported erectile dysfunction assessment at MESA Exam 5 (2010-2012). They were followed for a median of 3.8 (interquartile range, 3.5 – 4.2) years. In Model 3, HR was adjusted for age, race/ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, antihypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate.

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Key findings of the study include:

• 94 cases of incident atrial fibrillation were observed.


• There was a significant difference between men with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%).


• In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (Model 3; HR, 1.66).

"Among older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation," concluded the authors.

The study, "Association of erectile dysfunction with incident atrial fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA)," is published in the American Journal of Medicine.

DOI: https://doi.org/10.1016/j.amjmed.2019.08.052