ORLANDO — Racial differences in prevalence of erectile dysfunction in a large study were independent of traditional risk factors, including age, medical comorbidity, current tobacco use, and obesity.
Increased cardiovascular disease and diabetes risk in some racial groups prompted the study. Using Kaiser Permanente data, researchers for the California Men's Health Study assessed 81,426 men who self-reported African American, Hispanic, Asian/Pacific Islander, white, or other/multiple ethnicity and compared prevalence rates of erectile dysfunction (ED). Men of ethnic minorities were oversampled and represented 35% of the cohort.
Dr. James F. Smith and his associates found elevated ED prevalence in all other groups, compared with the white group. In a multivariate model, race data were adjusted for age, medical comorbidity, obesity, tobacco use, education, and income. Compared with a reference group of white men (odds ratio, 1.0), Asian/Pacific Islander men had a slight, nonsignificant increase in ED prevalence (OR, 1.06). However, African American (OR, 1.09), other/multiple ethnicity (OR, 1.16), and Hispanic men (OR, 1.19) had significantly higher prevalence rates.
“Small prevalence differences may have significant public health implications,” said Dr. Smith, an andrology fellow in the department of urology, University of California, San Francisco.
There was an inverse linear relationship between ED and higher income. For example, risk of ED was almost 50% higher for those who earned $20,000 or less versus men who earned $100,000 or more.
“We need to tell our patients to stop smoking, to lose weight, and to make a lot of money,” Dr. Smith said at the annual meeting of the American Urological Association. The study was funded by the California Cancer Research Program.
The researchers also confirmed clear associations between ED and traditional risk factors including older age, tobacco use, increased body mass index, cardiovascular disease, and diabetes. Men with diabetes were more likely to have ED (OR, 2.4), as were those with cardiovascular disease (OR, 1.7) or who currently used tobacco (OR, 1.4).
“There were clear associations between age and ED,” Dr. Smith said. For every 10-year increase in age, there was a 2.2 OR increase in risk of ED. Overall, ED prevalence rose from 13% of men aged 45–49 years, to 24% for men aged 50–59 years, to 44% for men aged 60–69 years. Similar increases with age were seen in all racial groups.
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