Sun P and Swindle R (2005) Are men with erectile dysfunction more likely to have hypertension than men without erectile dysfunction? A naturalistic national cohort study. J Urol 174: 244–248

A naturalistic cohort study has shown that men with erectile dysfunction (ED) are more likely to have hypertension than men without ED. Many researchers have asserted that ED coexists with other diseases such as hypertension, but few previous studies have directly compared men with and without ED for hypertension at a large population level.

The study included 285,436 men with ED, and 1,584,230 men without ED from a managed-care claims database in the US. Participants were assigned as having ED, hypertension, or other concurrent diseases by the existence of one or more claims to the disease, with a disease–related diagnosis code. The authors note that there are limitations with using data from commercial health plans.

Results of the study showed that 41.2% of men with ED had hypertension, compared with 19.2% of men without ED. When controlling for age, census region and 9 concurrent diseases, the likelihood of men with ED having hypertension was 38.3% higher than the likelihood for men without ED. The authors hypothesize that ED shares common risk factors with hypertension, including hemodynamic abnormality. The study also shows that hypertension treatments are not a major risk factor for ED, because 38% of patients made ED claims before they made hypertension claims.

The investigators recommend that patients and clinicians should use observable ED as an alert to unobservable hypertension.