Vascular and Chronological Age in Men With Erectile Dysfunction: A Longitudinal Study

Area of Science:

• Cardiology
• Vascular Medicine
• Men's Health

Background:

• Impaired penile vascularity on Doppler ultrasound predicts major adverse cardiovascular (CV) events (MACE), especially in low-risk men.
• Penile Doppler ultrasound is not routinely recommended for cardiovascular risk assessment.

Purpose of the Study:

• To determine if the difference between vascular and chronological age (Δage), calculated using the SCORE algorithm, predicts MACE in men seeking evaluation for erectile dysfunction (ED).
• To assess if Δage is an independent predictor of MACE, even when considering other CV risk factors and penile Doppler ultrasound parameters.

Main Methods:

• Retrospective analysis of 1687 male patients initially presenting for ED.
• SCORE algorithm applied to 841 patients; 739 MACE-free patients analyzed.
• Vascular age derived from SCORE, Δage calculated; MACE data obtained from the City of Florence Registry Office.

Main Results:

• Δage was significantly associated with incident MACE.
• This association persisted in low-risk subjects (younger age, no CV family history, no metabolic syndrome) even after adjusting for confounders.
• The predictive value of Δage for MACE remained significant, independent of penile Doppler ultrasound findings.

Conclusions:

• In men with ED, Δage serves as a significant predictor of incident MACE, particularly in those at low cardiovascular risk.
• Δage is a cost-effective and safe surrogate marker for penile vascular damage and cardiovascular risk assessment.
• The predictive capability of Δage is independent of traditional CV risk factors and penile vascular parameters.