Evaluation of Cardiovascular Risk of Patients with Erectile Dysfunction in the Primary Care Center Group of Matosinhos (ACES Matosinhos)

Abstract

Introduction: Erectile dysfunction is defined as the persistent inability to achieve/maintain an erection that allows satisfactory sexual performance. The physiopathology of erectile dysfunction shares some similarities with cardiovascular disease, including atherosclerosis, endothelial dysfunction, structural vascular damage, and subclinical inflammation. The early management of erectile dysfunction seems to reduce the risk of major cardiovascular events, because erectile dysfunction has a significant predictive value for major cardiovascular events. This study aims to stratify patients with erectile dysfunction according to cardiovascular risk to standardize the diagnostic and therapeutic approach to be implemented.
Methods: This study is observational and descriptive aimed at assessing cardiovascular risk in men with erectile dysfunction. The study involved a sample of male individuals aged 40 and above diagnosed with erectile dysfunction coded as Y07 (“Impotence”) according to the ICPC-2 classification, at Matosinhos Primary Health Care Unit in 2022.
Results: Fourteen Matosinhos Primary Health Care Units were analyzed, comprising a total of 720 patients coded with Y07 with at least 40 years of age. The mean age was 67 years, ranging from 40 to 97 years. Regarding comorbidities, based on ICPC-2 codification, 566 patients had dyslipidemia, 605 hypertension, 337 diabetes mellitus, and 208 obesity. A total of 178 patients were smokers, and 64 had alcohol habits. The results showed that 128 patients had ischemic heart disease, with 50 having an episode of acute myocardial infarction and 32 experiencing a cerebral stroke. Notably, 224 patients had a cardiovascular risk equal to 5%, and 309 had a cardiovascular risk equal to 10%.
Conclusion: Addressing erectile dysfunction in the context of primary healthcare remains a challenge. The systematic approach, compared to other predictors of cardiovascular risk, such as arterial hypertension or lipid profile, contributes to the optimization of cardiovascular risk, since it is an independent predictor of CV risk. This study aligns with existing research, as the majority of erectile dysfunction patients displayed high or very high cardiovascular risk. Therefore, it is important to question the sexual pattern to identify cases of ED and, depending on CV risk, carry out a diagnostic study and an appropriate therapeutic approach.