The prevalence of cardiovascular disease in male patients with type 2 diabetes mellitus and erectile dysfunction, along with an assessment of shared cardiovascular risk factors
CVD prevalence and the risk factors in T2DM males with ED
Keywords:
cardiovascular disease, diabetes, endothelial dysfunction, erectile dysfunctionAbstract
In men with T2DM, ED is correlated with increased rates of cardiovascular events when compared to men with T2DM who do not experience ED. This association suggests the presence of underlying health issues that require timely intervention. The objective of this study was to examine the cardiovascular risk in men with T2DM and ED. Identifying these risk factors may facilitate preventive measures to improve clinical outcomes in this high-risk population. Participants were categorized into two groups based on their CVD status. A comparative analysis of the two groups was conducted on age, the presence of neuropathy, tobacco usage, and alcohol consumption. CVD was present in 51.6 % of the total sample. In both groups, the mean qualification years, duration of diabetes, BMI, cholesterol levels, prevalence of hypertension, and use of drugs affecting ED were similar. Patients in the CVD group were older, smoked, used alcohol, and had CVD more frequently. In males with T2DM and ED, increased ischemic heart disease, stroke, and peripheral vascular complications were all increased. Our analysis indicates a direct association between ED and CVD in males with T2DM, suggesting a more complex relationship in which ED may function as a contributing indicator of more advanced disease.
Downloads
References
Bivalacqua, T. J., Allen, B. K., Brock, G. B., Broderick, G. A., Chou, R., Kohler, T. S., ... & Bennett Jr, N. E. (2022). The diagnosis and management of recurrent ischemic priapism, priapism in sickle cell patients, and non-ischemic priapism: an AUA/SMSNA guideline. Journal of Urology, 208(1), 43-52. DOI: https://doi.org/10.1097/JU.0000000000002767
Blumentals, W. A., Gomez-Caminero, A., Joo, S., & Vannappagari, V. (2004). Should erectile dysfunction be considered as a marker for acute myocardial infarction? Results from a retrospective cohort study. International Journal of Impotence Research, 16(4), 350-353. DOI: https://doi.org/10.1038/sj.ijir.3901174
Bozkurt, B., Aguilar, D., Deswal, A., Dunbar, S. B., Francis, G. S., Horwich, T., ... & Yancy, C. (2016). Contributory risk and management of comorbidities of hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome in chronic heart failure: a scientific statement from the American Heart Association. Circulation, 134(23), e535-e578. DOI: https://doi.org/10.1161/CIR.0000000000000450
Burnett, A. L. (2003). Pathophysiology of priapism: dysregulatory erection physiology thesis. The Journal of urology, 170(1), 26-34. https://doi.org/10.1097/01.ju.0000046303.22757.f2 DOI: https://doi.org/10.1097/01.ju.0000046303.22757.f2
Burnett, A. L. (2006). The role of nitric oxide in erectile dysfunction: implications for medical therapy. The Journal of Clinical Hypertension, 8, 53-62. DOI: https://doi.org/10.1111/j.1524-6175.2006.06026.x
Corona, G., Rastrelli, G., Isidori, A. M., Pivonello, R., Bettocchi, C., Reisman, Y., ... & Maggi, M. (2020). Erectile dysfunction and cardiovascular risk: a review of current findings. Expert review of cardiovascular therapy, 18(3), 155-164. DOI: https://doi.org/10.1080/14779072.2020.1745632
Dilixiati, D., Waili, A., Tuerxunmaimaiti, A., Tao, L., Zebibula, A., & Rexiati, M. (2024). Risk factors for erectile dysfunction in diabetes mellitus: a systematic review and meta-analysis. Frontiers in Endocrinology, 15, 1368079. DOI: https://doi.org/10.3389/fendo.2024.1368079
Eckel, R. H., Bornfeldt, K. E., & Goldberg, I. J. (2021). Cardiovascular disease in diabetes, beyond glucose. Cell metabolism, 33(8), 1519-1545. DOI: https://doi.org/10.1016/j.cmet.2021.07.001
Fakhruddin, S., Alanazi, W., & Jackson, K. E. (2017). Diabetes‐induced reactive oxygen species: mechanism of their generation and role in renal injury. Journal of diabetes research, 2017(1), 8379327. DOI: https://doi.org/10.1155/2017/8379327
Förstermann, U., & Li, H. (2011). Therapeutic effect of enhancing endothelial nitric oxide synthase (eNOS) expression and preventing eNOS uncoupling. British journal of pharmacology, 164(2), 213-223. DOI: https://doi.org/10.1111/j.1476-5381.2010.01196.x
Hamur, H., Duman, H., Keskin, E., Inci, S., Kucuksu, Z., Degirmenci, H., & Topal, E. (2015). The relation between erectile dysfunction and extent of coronary artery disease in the patients with stable coronary artery disease. International journal of clinical and experimental medicine, 8(11), 21295.
Handelsman, D. J., Yeap, B. B., Flicker, L., Martin, S., Wittert, G. A., & Ly, L. P. (2015). Age-specific population centiles for androgen status in men. European journal of endocrinology, 173(6), 809-817. DOI: https://doi.org/10.1530/EJE-15-0380
Hegazy, M. W., Mahmood, R. I., Al Otaibi, M. F., & Khalil, E. M. (2016). Hypofractionated volumetric modulated arc radiotherapy with simultaneous elective nodal irradiation is feasible in prostate cancer patients: a single institution experience. Journal of the Egyptian National Cancer Institute, 28(2), 101-110. https://doi.org/10.1016/j.jnci.2016.04.001 DOI: https://doi.org/10.1016/j.jnci.2016.04.001
Jackson, G., Betteridge, J., Dean, J., Eardley, I., Hall, R., Holdright, D., ... & Sever, P. (2002). A systematic approach to erectile dysfunction in the cardiovascular patient: a Consensus Statement--update 2002. International journal of clinical practice, 56(9), 663-671. DOI: https://doi.org/10.1111/j.1742-1241.2002.tb11349.x
Kessler, A., Sollie, S., Challacombe, B., Briggs, K., & Van Hemelrijck, M. (2019). The global prevalence of erectile dysfunction: a review. BJU international, 124(4), 587-599. DOI: https://doi.org/10.1111/bju.14813
Khanna, N. N., Maindarkar, M., Saxena, A., Ahluwalia, P., Paul, S., Srivastava, S. K., ... & Suri, J. S. (2022). Cardiovascular/stroke risk assessment in patients with erectile dysfunction—a role of carotid wall arterial imaging and plaque tissue characterization using artificial intelligence paradigm: a narrative review. Diagnostics, 12(5), 1249. DOI: https://doi.org/10.3390/diagnostics12051249
Marma, A. K., & Lloyd-Jones, D. M. (2009). Systematic examination of the updated Framingham heart study general cardiovascular risk profile. Circulation, 120(5), 384-390. DOI: https://doi.org/10.1161/CIRCULATIONAHA.108.835470
O'Donnell, A. B., Araujo, A. B., & McKinlay, J. B. (2004). The health of normally aging men: the Massachusetts Male Aging Study (1987–2004). Experimental gerontology, 39(7), 975-984. https://doi.org/10.1016/j.exger.2004.03.023 DOI: https://doi.org/10.1016/j.exger.2004.03.023
Oyelade, B. O., Jemilohun, A. C., & Aderibigbe, S. A. (2016). Prevalence of erectile dysfunction and possible risk factors among men of South-Western Nigeria: a population based study. Pan African Medical Journal, 24(1).
Pacinella, G., Ciaccio, A. M., & Tuttolomondo, A. (2022). Endothelial dysfunction and chronic inflammation: the cornerstones of vascular alterations in age-related diseases. International Journal of Molecular Sciences, 23(24), 15722. DOI: https://doi.org/10.3390/ijms232415722
Pizzol, D., Smith, L., Fontana, L., Caruso, M. G., Bertoldo, A., Demurtas, J., ... & Veronese, N. (2020). Associations between body mass index, waist circumference and erectile dysfunction: a systematic review and META-analysis. Reviews in Endocrine and Metabolic Disorders, 21, 657-666. DOI: https://doi.org/10.1007/s11154-020-09541-0
Quilter, M., Hodges, L., von Hurst, P., Borman, B., & Coad, J. (2017). Male sexual function in New Zealand: a population-based cross-sectional survey of the prevalence of erectile dysfunction in men aged 40–70 years. The journal of sexual medicine, 14(7), 928-936. DOI: https://doi.org/10.1016/j.jsxm.2017.05.011
Rübsam, A., Parikh, S., & Fort, P. E. (2018). Role of inflammation in diabetic retinopathy. International journal of molecular sciences, 19(4), 942. DOI: https://doi.org/10.3390/ijms19040942
Saffati, G., Seyan, Z., Rendon, D. O., Almuhaideb, M., Hinojosa-Gonzalez, D. E., Kronstedt, S., & Khera, M. (2025). Erectile dysfunction as a holistic indicator of well-being: a narrative review. Sexual Medicine Reviews, 13(1), 11-19. DOI: https://doi.org/10.1093/sxmrev/qeae066
Tarnutzer, A. A., Lee, S. H., Robinson, K. A., Wang, Z., Edlow, J. A., & Newman-Toker, D. E. (2017). ED misdiagnosis of cerebrovascular events in the era of modern neuroimaging: a meta-analysis. Neurology, 88(15), 1468-1477. DOI: https://doi.org/10.1212/WNL.0000000000003814
Terentes-Printzios, D., Ioakeimidis, N., Rokkas, K., & Vlachopoulos, C. (2022). Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nature Reviews Cardiology, 19(1), 59-74. DOI: https://doi.org/10.1038/s41569-021-00593-6
Vovk, A., Wild, F., Guest, W., & Kuula, T. (2018). Simulator sickness in augmented reality training using the Microsoft HoloLens. In Proceedings of the 2018 CHI conference on human factors in computing systems (pp. 1-9). DOI: https://doi.org/10.1145/3173574.3173783
Zhang, F., Li, Y., Shi, Z., & Wang, A. (2024). Sexual experience in patients with coronary heart disease: a descriptive phenomenological study. Scientific Reports, 14(1), 9968. DOI: https://doi.org/10.1038/s41598-024-60496-7
Published
How to Cite
Issue
Section
Copyright (c) 2025 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.