scholarly journals The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

2017 ◽  
Vol 23 (1) ◽  
pp. 9-20 ◽  
Author(s):  
Chukwuemeka U Osondu ◽  
Bryan Vo ◽  
Ebenezer T Oni ◽  
Michael J Blaha ◽  
Emir Veledar ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Vascular Function ◽  
Meta Analysis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Publication Date ◽  
Cvd Risk ◽  
The Relationship ◽  
Subclinical Cvd

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) and CVD mortality. However, the relationship between ED and subclinical CVD is less clear. We synthesized the available data on the association of ED and measures of subclinical CVD. We searched multiple databases for published literature on studies examining the association of ED and measures of subclinical CVD across four domains: endothelial dysfunction measured by flow-mediated dilation (FMD), carotid intima–media thickness (cIMT), coronary artery calcification (CAC), and other measures of vascular function such as the ankle–brachial index, toe–brachial index, and pulse wave velocity. We conducted random effects meta-analysis and meta-regression on studies that examined an ED relationship with FMD (15 studies; 2025 participants) and cIMT (12 studies; 1264 participants). ED was associated with a 2.64 percentage-point reduction in FMD compared to those without ED (95% CI: –3.12, −2.15). Persons with ED also had a 0.09-mm (95% CI: 0.06, 0.12) higher cIMT than those without ED. In subgroup meta-analyses, the mean age of the study population, study quality, ED assessment questionnaire (IIEF-5 or IIEF-15), or the publication date did not significantly affect the relationship between ED and cIMT or between ED and FMD. The results for the association of ED and CAC were inconclusive. In conclusion, this study confirms an association between ED and subclinical CVD and may shed additional light on the shared mechanisms between ED and CVD, underscoring the importance of aggressive CVD risk assessment and management in persons with ED.

Abstract 718: The Association of Erectile Dysfunction with Carotid Intima Media Thickness and Endothelial Dysfunction: A Meta-Analysis

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Bryan D Vo ◽  
Ehimen Aneni ◽  
Ebenezer Oni ◽  
Wazim Maziak ◽  
Theodore Feldman ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Meta Analysis ◽  
Random Effect ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Individual Participant Data ◽  
Media Thickness ◽  
Individual Participant ◽  
The Relationship ◽  
Random Effect Models

Introduction: A recent meta-analysis showed that erectile dysfunction (ED) was associated with elevated cardiovascular disease (CVD) mortality. However, findings from studies examining the relationship between ED and sub-clinical CVD have been conflicting. This study summarizes the current evidence related to the association of ED and vascular disease as measured by flow mediated dilation (FMD) of the endothelium and carotid intima media thickness (CIMT). Methods: We searched multiple internet databases for published literature on studies assessing the association of ED and FMD, and CIMT between 1964 and 2014. A total of 11 studies met the inclusion criteria for examining the association between ED and FMD, while 7 studies met criteria for assessing the association with CIMT. Fixed-effect and random-effect models were used to assess and compare the standardized mean difference (SMD) of FMD and CIMT between persons with and without ED. Results: From a total of 795 individual participant data (590 with and 205 without ED), persons with ED had a 0.66mm (0.49, 0.83) increase in CIMT by fixed effects model or 0.67mm (0.44, 0.90) by random effects model compared to those without ED. Similarly, from 1055 individual participant data (536 with and 419 without ED), ED was associated with a significant reduction in FMD by both fixed effect (-1.10% (95% CI: -2.10, -0.95)) and random effect models (-1.53% (95% CI: -2.10, -0.95)). There was significant heterogeneity among studies assessing the relationship between ED and FMD (I2 = 93.2%, p<0.001) but not among those comparing CIMT among persons with ED (I2 = 43.5% p=0.09). Conclusion: This study confirms that ED is associated with both worsening endothelial function and increased CIMT. Thus, worsening vascular function may be a pathogenic mechanism for increased CVD morbidity and mortality in persons with ED. A diagnosis of ED should prompt a thorough CV work-up and aggressive preventive management.

Abstract P006: Flow-Mediated Dilation is Inversely Associated with Cardiovascular Disease Risk: a Meta-Analysis of Prospective Studies

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Rouyanne T Ras ◽  
Martinette T Streppel ◽  
Peter L Zock ◽  
Richard Draijer
Keyword(s):  
Cardiovascular Disease ◽  
Health Status ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Risk Estimate ◽  
Flow Mediated Dilation ◽  
Cvd Risk ◽  
Risk Estimates ◽  
The Relationship ◽  
Overall Risk

Background - Flow-mediated dilation (FMD) is an accepted technique to quantify endothelial (dys)function. The predictive value of FMD for future cardiovascular disease (CVD) risk has been investigated in several prospective studies. The purpose of the present study was to systematically review these studies and to quantify the relationship between FMD and CVD risk. It was hypothesized that the risk of experiencing a cardiovascular event later in life would be smaller when having a higher FMD value at baseline. Methods - Potentially relevant prospective studies were searched in several databases and by hand searching, through March 2011. Studies were selected based on predefined selection criteria. The statistical analysis was performed separately for continuous (per 1% increase in FMD) and categorical (when having a high vs. low FMD) risk estimates for CVD. The pooled overall risk estimate was calculated based on a random-effects model while weighting each study by the inverse of its variance. Potential sources of heterogeneity were investigated as well as presence of publication bias. Results - In total, 23 studies including 14,753 subjects were eligible for inclusion in the present meta-analysis. Subjects were followed for an average duration of 42.9 months (range: 12.1-94.6 months). The average age was 60.1 years (range: 46.0-78.6 years). In 8 out of 23 studies, asymptomatic subjects were included whereas in 15 studies, subjects were diagnosed as having various forms of diseases. In studies reporting continuous risk estimates, the pooled overall risk estimate for CVD expressed per 1 % increase in FMD was 0.90 (95%CI: 0.86, 0.94). One study, that was the only study including exclusively renal patients, reported results that significantly differed from this estimate. Excluding this study from the analysis did not materially affect the pooled overall risk estimate (RR = 0.92 (95%CI: 0.88; 0.95). Based on studies with categorical risk estimates, the pooled overall risk estimate for CVD when having a high FMD vs. a low FMD was 0.49 (95%CI: 0.38, 0.63). Covariate analysis revealed that health status significantly affected the association between FMD and CVD risk with a stronger association in diseased populations. Presence of publication bias could not be excluded. Conclusions - Our findings show that baseline FMD is inversely associated with CVD risk, particularly in diseased populations. Further studies should address the impact of underlying health status on the relationship between FMD and CVD.

scholarly journals Premature Parental Cardiovascular Disease and Subclinical Disease Burden in the Offspring

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Wolfgang Lieb ◽  
Rebecca J. Song ◽  
Ramachandran S. Vasan ◽  
Vanessa Xanthakis
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cut Points ◽  
Media Thickness ◽  
Vascular Beds ◽  
Subclinical Cvd

Background Offspring of parents with premature cardiovascular disease (CVD) have an increased risk of developing subclinical and clinical CVD. It is unclear whether this association differs by vascular beds in the offspring or by the age cut points used to define premature parental CVD. Methods and Results Using 3 generations of Framingham Heart Study participants, we assessed prevalent coronary artery calcification, the progression of coronary artery calcification over 6.1 years (median), carotid intima media thickness and the ankle‐brachial index in 1046 offspring of parents with premature CVD before age 70 years, in 1618 offspring with both parents free of CVD and in 923 offspring with parents with CVD after age 70 years. We used different age cut points (55, 60, 65, and 70 years) to define premature parental CVD. In multivariable‐adjusted models, offspring of parents with premature CVD (onset before age 65 years) displayed greater odds for prevalent coronary artery calcification (odds ratio [OR], 1.81; 95% CI, 1.35–2.43), higher carotid intima media thickness (OR, 1.50; 95% CI, 0.92–2.44) and lower ankle‐brachial index (OR, 1.89; 95% CI, 1.00–3.58). These associations were generally consistent across different age cut points used to define premature parental CVD. The association with the progression of coronary artery calcification was less consistent. Conclusions Parental premature CVD is associated with increased subclinical CVD burden in the offspring, with consistent relations across different vascular beds and for different age cut points used to define premature parental CVD. Future studies should evaluate whether screening for subclinical CVD traits is warranted in offspring with premature parental CVD.

scholarly journals Reproductive Hormones and Subclinical Cardiovascular Disease in Midlife Women

2018 ◽  
Vol 103 (8) ◽  
pp. 3070-3077 ◽  
Author(s):  
Rebecca C Thurston ◽  
Shalender Bhasin ◽  
Yuefang Chang ◽  
Emma Barinas-Mitchell ◽  
Karen A Matthews ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Cardiovascular Disease ◽  
Endothelial Function ◽  
Postmenopausal Women ◽  
Intima Media Thickness ◽  
Reproductive Hormones ◽  
Cvd Risk ◽  
Liquid Chromatography Tandem Mass ◽  
Subclinical Cardiovascular Disease ◽  
Subclinical Cvd

Abstract Context Reproductive hormones are important to the pathophysiology of cardiovascular disease (CVD) in women. However, standard estradiol (E2) and testosterone (T) assays lack sensitivity at the levels of postmenopausal women. Objective Investigate relations of mass spectrometry–assessed estrone (E1), E2, and T and SHBG and subclinical CVD in women. Design, Setting, and Participants Three hundred and four perimenopausal and postmenopausal women aged 40 to 60 years underwent subclinical CVD measurements. E1, E2, and T were assayed using liquid chromatography–tandem mass spectrometry; free T (FT) was estimated using ensemble allostery models. Regression models were adjusted for CVD risk factors. Main Outcome Measures Carotid artery intima media thickness, interadventitial diameter (IAD), and plaque; brachial flow mediated dilation (FMD). Results Higher E1 was related to higher FMD [β(SE) = 0.77 (0.37), P = 0.04], indicating better endothelial function. Higher E2 was related to lower IAD [β(SE) = −0.07 (0.02), P = 0.004], indicating less carotid remodeling. Higher SHBG was related to higher FMD [β(SE) = 1.31 (0.40), P = 0.001], yet higher IAD [β(SE) = 0.15 (0.06), P = 0.02] and plaque [OR (95% CI) = 1.84 (1.16 to 2.91), P = 0.009]; FT showed a similar yet inverse pattern of relations as SHBG. Thus, higher SHBG and lower FT were associated with better endothelial function, yet greater carotid remodeling and plaque. Conclusions Endogenous E1 levels were related to endothelial function and E2 to vascular remodeling, suggesting distinct roles of these estrogens. SHBG and FT have complex roles depending on the vessel under study.

scholarly journals The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

2021 ◽  
Vol 10 (5) ◽  
pp. 955
Author(s):  
Ovidiu Mitu ◽  
Adrian Crisan ◽  
Simon Redwood ◽  
Ioan-Elian Cazacu-Davidescu ◽  
Ivona Mitu ◽  
...  
Keyword(s):  
Risk Score ◽  
Subclinical Atherosclerosis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Risk Scores ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Single Center Study ◽  
Asymptomatic Individuals

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals. Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI). Results: The mean age was 52.01 ± 10.73 years. For cIMT—SCORE was more sensitive; for PWV—Framingham score was more sensitive; for AIXbr—QRISK and PROCAM were more sensitive while for AIXao—QRISK presented better results. As for SBPao—SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score. Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

scholarly journals Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ali A. Weinstein ◽  
Preetha Abraham ◽  
Guoqing Diao ◽  
Stacey A. Zeno ◽  
Patricia A. Deuster
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African American ◽  
Depressive Symptoms ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Regression Analyses ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

Abstract P375: Vascular Age Versus Calendar Age as Surrogate for Atherosclerotic Burden and Cardiovascular Disease Risk

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Chronological Age ◽  
Specific Reference ◽  
Communication Tool ◽  
Vascular Age

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.

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