Causal association of cardiovascular disease with erectile dysfunction: a two-sample bidirectional Mendelian...

Area of Science:

• Cardiovascular medicine
• Genetics
• Urology

Background:

• Observational studies suggest a link between cardiovascular diseases (CVD) and erectile dysfunction (ED), but the causal relationship remains unclear.
• CVD encompasses conditions such as ischemic stroke (IS), heart failure (HF), myocardial infarction (MI), and coronary heart disease (CHD).

Purpose of the Study:

• To investigate the potential bidirectional causal association between various cardiovascular diseases and erectile dysfunction using Mendelian randomization (MR).

Main Methods:

• Utilized genome-wide association study data from European ancestry populations for CVD (1,711,875–977,323 participants) and ED (223,805 participants).
• Employed univariate MR (UVMR) and multivariate MR (MVMR) analyses, including inverse variance-weighting (IVW), weighted median, and MR-Egger methods, to assess causal effects.
• Explored potential mediation pathways for IS, HF, and CHD on ED, and vice versa.

Main Results:

• UVMR indicated significant associations between IS, HF, and CHD with ED.
• MVMR confirmed a significant causal effect of IS on ED, even after accounting for other CVD risk factors.
• Genetic susceptibility to ED did not show a causal effect on the risk of developing CVD.

Conclusions:

• Genetic predisposition to ischemic stroke, heart failure, and coronary heart disease is causally associated with erectile dysfunction.
• Findings suggest that ED in patients with IS, HF, and CHD may stem from underlying cardiovascular pathology, informing targeted prevention and intervention strategies.