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Elevated plasma aldosterone is an independent risk factor for erectile dysfunction in men

Erectile dysfunction and cardiovascular disease share a great number of common risk factors. There is growing evidence that aldosterone, an independent cardiovascular risk factor, is associated with erectile dysfunction.

The purpose of a study was to determine the relationship between plasma aldosterone and erectile dysfunction.

This study recruited 287 participants, ranging from 18 to 84 years old; 217 were suffering from erectile dysfunction, diagnosed by the International Index of Erectile Function 5 ( IIEF-5 ) scores.
Based on IIEF-5 scores, patients were divided into one control group and three erectile dysfunction groups ( mild erectile dysfunction; moderate erectile dysfunction; severe erectile dysfunction ).

The differences in principal characteristics, blood routine, sexual hormone, adrenal hormone, thyroid hormone, renal function, liver function and blood lipid were compared between erectile dysfunction and control groups.
The study demonstrated that the difference of mean plasma aldosterone levels between erectile dysfunction group and the control group was statistically significant ( P less than 0.05 ).

Stepwise logistic regression analysis of all the possible factors support the role of aldosterone as an independent risk factor for erectile dysfunction ( odds ratio, OR=1.011; 95 % CI 1.003–1.018; P = 0.004 ).

Similar statistical methods were applied to the comparison between moderate to severe erectile dysfunction group and control to mild erectile dysfunction group ( OR=1.017; 95 % CI 1.009–1.024; P less than 0.001 ).

ROC curve and the area under the curve ( 0.718; 95 % CI 0.643–0.794; P less than 0.001 ) were performed to assess the diagnostic effect and to compare the severity of risk with the known independent risk factors, such as age and cholesterol ( 0.704; 95 % CI 0.631–0.778; P less than 0.001 ).

When using a 374 pg/mL cut-off value from Youden index, the odds ratio of erectile dysfunction group versus controls is 3.106 ( 95 % CI 1.458–6.617 ), while the odds ratio of moderate to severe erectile dysfunction versus control and mild erectile dysfunction is 5.480 ( 95 % CI 3.108–9.662 ).

In conclusion, elevated plasma aldosterone concentration is an independent risk factor for erectile dysfunction.
The findings also indicate that the aldosterone, a well-recognized contributor to vascular injury, might be a potential bond between erectile dysfunction and cardiovascular disease. ( Xagena )

Wu F et al, World Journal of Urology 2015; First online