Article Figures & Data
Tables
Characteristic Blood Pressure Sample, No. (%)
(n=2,224)Cholesterol Sample, No. (%)
(n=2,287)Fasting Glucose Sample, No. (%)
(n=1,417)Erectile dysfunction No 1,874 (89.1) 1,813 (87.3) 1,090 (83.8) Yes 350 (10.9) 474 (12.7) 327 (16.2) Age-group, y 20–39 1,029 (49.8) 1,027 (51.5) 539 (43.6) 40–59 789 (40.3) 732 (37.1) 487 (40.5) ≥60 350 (9.9) 528 (11.5) 391 (15.9) Ethnicity White 1,142 (71.4) 1,158 (70.4) 788 (72.6) Black 391 (9.1) 441 (10.2) 242 (9.8) Mexican American 539 (10.2) 542 (10.1) 297 (8.5) Other 152 (9.3) 146 (9.3) 90 (9.1) Physically activea No 1,267 (58.1) 1,329 (59.4) 834 (61.2) Yes 957 (41.9) 958 (40.6) 583 (38.8) Alcohol use Never 159 (7.1) 164 (7.3) 97 (6.8) Former 195 (8.2) 209 (8.8) 130 (9.1) Current 1,870 (84.6) 1,914 (83.8) 1,190 (84.1) Current smoker No 1,559 (69.8) 1,596 (68.6) 1,043 (72.5) Yes 665 (30.2) 691 (31.4) 374 (27.5) History of hypertension No 2,224 (100.0) 1,799 (82.4) 1,042 (75.6) Yes 0 (0.0) 488 (17.6) 375 (24.4) History of high cholesterol No 1,779 (79.5) 2,287 (100.0) 1,025 (72.2) Yes 445 (20.5) 0 (0.0) 392 (27.8) History of diabetes No 2,130 (96.9) 2,159 (96.8) 1,417 (100.0) Yes 94 (3.1) 128 (3.2) 0 (0.0) History of cardiovascular diseaseb No 2,154 (97.7) 2,160 (96.8) 1,282 (93.4) Yes 70 (2.3) 127 (3.2) 135 (6.6) Family history of hypertension/strokec No 1,668 (72.8) 1,669 (70.5) 1,028 (69.6) Yes 556 (27.2) 618 (29.5) 389 (30.4) Family history of angina/heart attackc No 1,985 (87.0) 2,043 (87.0) 1,263 (86.6) Yes 239 (13.0) 244 (13.0) 154 (13.4) Family history of diabetes No 1,217 (54.3) 1,262 (55.3) 779 (54.8) Yes 1,007 (45.7) 1,025 (44.7) 638 (45.2) Weight statusd Normal weight/underweight 681 (30.8) 689 (30.8) 364 (25.4) Overweight 760 (33.6) 727 (31.3) 476 (33.2) Obese 783 (35.7) 871 (37.9) 577 (41.5) Undiagnosed disease No 1,933 (89.3) 2,017 (87.9) 1,352 (95.8) Yese 291 (10.4) 270 (12.1) 65 (4.2) Note: All percentages are probability weighted to account for the National Health and Nutrition Examination Survey sampling design.
↵a Men responding “more active” to the question “Compared with most men your age, would you say that you are …” were considered to be physically active; those responding “less active” or “about the same” were considered not physically active.
↵b Included angina, heart attack, coronary heart disease, congestive heart failure, or stroke.
↵c Before the age of 50.
↵d Using World Health Organization classification: obese (body mass index [BMI] ≥30 kg/m2 or waist circumference [WC] ≥102 cm), overweight (BMI ≥25 kg/m2 but <30 kg/m2 or WC ≥94 cm but <102 cm), or normal weight or underweight (BMI <25 kg/m2 or WC <94 cm).
↵e Undiagnosed hypertension: average systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg; undiagnosed hypercholesterolemia: total cholesterol ≥6.21 mmol/L (≥240 mg/dL); undiagnosed diabetes: fasting plasma glucose level ≥126 mg/dL (≥7.0 mmol/L).
- Table 2
Odds Ratios (95% CIs) for Association of Erectile Dysfunction With Undiagnosed Hypertension, Hypercholesterolemia, and Diabetes Among Men Aged ≥20 Years in NHANES 2001–2004
Undiagnosed Hypertension (n=2,224) Undiagnosed Hypercholesterolemia (n=2,287) Undiagnosed Diabetes (n=1,417) Characteristic Unadjusted OR (95% CI) Adjusted OR (95% CI) Unadjusted OR (95% CI) Adjusted OR (95% CI) Unadjusted OR (95% CI) Adjusted OR (95% CI) Erectile dysfunction 2.35 (1.78–3.11) 1.27 (0.87–1.85) 0.73 (0.47–1.15) 0.67 (0.42–1.07) 4.58 (2.54–8.24) 2.20 (1.10–4.37)a Age-group, y 20–39 (ref) 1.00 1.00 1.00 1.00 1.00 1.00 40–59 2.47 (1.69–3.61) 2.38 (1.55–3.66)a 1.88 (1.25–2.84) 1.84 (1.24–2.75)a 8.24 (2.49–27.19) 5.56 (1.78–17.35)a ≥60 7.29 (4.90–10.84) 7.41 (4.43–12.37)a 1.12 (0.76–1.65) 1.45 (0.87–2.43) 14.83 (5.19–42.34) 8.70 (2.91–26.03)a Ethnicity Non-Hispanic white (ref) 1.00 1.00 1.00 1.00 1.00 1.00 Non-Hispanic black 1.47 (1.07–2.02) 1.99 (1.34–2.97)a 0.76 (0.47–1.23) 0.87 (0.54–1.40) 0.78 (0.39–1.56) 1.25 (0.57–2.71) Mexican American 0.64 (0.41–0.98) 0.90 (0.60–1.35) 0.92 (0.64–1.31) 0.97 (0.65–1.46) 0.25 (0.11–0.58) 0.53 (0.21–1.33) Other 0.66 (0.34–1.30) 0.92 (0.46–1.85) 1.13 (0.64–1.99) 1.37 (0.77–2.44) 1.21 (0.46–3.15) 2.39 (0.87–6.55) Physically active 0.99 (0.77–1.28) 0.84 (0.62–1.13) 0.82 (0.59–1.14) 0.84 (0.60–1.18) 0.70 (0.33–1.47) 0.73 (0.35–1.55) Alcohol use Never (ref) 1.00 1.00 1.00 1.00 1.00 1.00 Former 1.57 (0.78–3.17) 1.31 (0.53–3.25) 1.28 (0.54–3.04) 0.90 (0.36–2.26) 1.73 (0.56–5.36) 1.42 (0.47–4.30) Current 0.85 (0.47–1.51) 0.95 (0.44–2.06) 3.12 (1.57–6.21) 2.48 (1.20–5.10)a 0.62 (0.23–1.68) 0.67 (0.29–1.55) Current smoker 0.65 (0.43–0.98) 0.82 (0.50–1.32) 1.59 (1.16–2.18) 1.65 (1.17–2.32)a 0.57 (0.25–1.34) 1.00 (0.41–2.41) History of hypertension n/ab n/ab 1.10 (0.72–1.68) 0.95 (0.56–1.61) 3.88 (2.16–6.96) 1.83 (0.92–3.65) History of high cholesterol 1.21 (0.87–1.68) 0.71 (0.48–1.05) n/ab n/ab 2.89 (1.68–4.98) 1.55 (0.81–2.99) History of diabetes 0.96 (0.46–1.98) 0.56 (0.28–1.14) 0.54 (0.27–1.08) 0.45 (0.21–0.97)a n/ab n/ab History of cardiovascular disease 1.11 (0.45–2.74) 0.59 (0.20–1.76) 1.20 (0.62–2.33) 1.24 (0.60–2.59) 1.48 (0.71–3.07) 0.46 (0.18–1.17) Family history of hypertension/stroke 0.90 (0.60–1.35) 1.22 (0.76–1.95) 0.75 (0.53–1.06) 0.68 (0.47–0.99)a 0.93 (0.54–1.62) 0.96 (0.54–1.72) Family history of angina/heart attack 0.59 (0.38–0.92) 0.68 (0.41–1.13) 1.12 (0.71–1.78) 1.18 (0.74–1.90) 1.36 (0.65–2.86) 1.26 (0.50–3.14) Family history of diabetes 0.93 (0.74–1.18) 1.02 (0.78–1.32) 1.33 (0.95–1.87) 1.30 (0.92–1.84) 2.24 (1.40–3.59) 2.35 (1.50–3.68)a Weight status Normal weight/underweight (ref) 1.00 1.00 1.00 1.00 1.00 1.00 Overweight 2.10 (1.45–3.04) 1.75 (1.15–2.67)a 2.23 (1.51–3.30) 2.17 (1.46–3.23)a 2.83 (0.74–10.81) 2.28 (0.74–6.99) Obese 3.11 (2.18–4.46) 2.37 (1.64–3.43)a 2.79 (1.70–4.58) 2.74 (1.68–4.47)a 5.98 (1.69–21.10) 3.60 (1.30–9.93)a
Additional Files
Supplemental Figure
Supplementary Figure. Flowchart depicting creation of three analytic subsamples (Blood Pressure, Cholesterol, Fasting Glucose) from NHANES 2001-2004 for undiagnosed hypertension, hypercholesterolemia and diabetes.
Files in this Data Supplement:
- Supplemental data: Figure - PDF file
The Article in Brief
Erectile Dysfunction and Undiagnosed Diabetes, Hypertension, and Hypercholesterolemia
Sean C. Skeldon , and colleagues
Background Previous research suggests that erectile dysfunction is an early indicator for cardiovascular disease. This study examines whether there is an association between erectile dysfunction and undiagnosed hypertension, hypercholesterolemia, or diabetes.
What This Study Found Erectile dysfunction doubles the odds of having undiagnosed diabetes. For an average man aged 40 to 59 years, the probability of undiagnosed diabetes jumps from one in 50 to one in 10 in men with erectile dysfunction. There is no association between erectile dysfunction and undiagnosed hypertension or hypercholesterolemia.
Implications
- The authors call for physicians to be vigilant in obtaining sexual histories in middle-aged men and screening those with erectile dysfunction for diabetes.
