Screening for cardiovascular disease (CVD) in men who present with erectile dysfunction (ED) can be a cost-effective intervention for the secondary prevention of both conditions, according to a new study.

“As the link between the etiologies of ED and CVD grows stronger, both the healthcare community and patients stand to benefit from screening for and treating CVD in men with ED,” researchers wrote in an online report in the Journal of Sexual Medicine. "Such an approach could significantly decrease national healthcare costs and disease burden with significant societal implications.”

Using the known incidence and prevalence of ED and CVD, the rate of undiagnosed CVD, and the effects of CVD, Alexander W. Pastuszak, MD, PhD, of the Center for Reproductive Medicine at Baylor College of medicine in Houston, and colleagues modeled the change in prevalence of acute CVD events and ED as a function of the number of men with ED and CVD.

Dr. Pastuszak's group found that men with CVD had a 47% increased relative risk of ED. They estimated that the co-prevalence of ED and CVD was 1,991,520 men. Additionally, 44% of men with CVD risk factors are unaware of their risk, they noted. CVD screening of all men who presented with ED would identify 5.8 million men with previously unknown CVD risk factors over 20 years at a cost of $2.7 billion to screen, the researchers reported. Assuming screening and subsequent treatment results in a 20% decrease in cardiovascular events, 1.1 million cardiovascular events would be avoided, for a cost savings of $21.3 billion over 20 years.

The investigators stated that based on their model, “we call for a paradigm shift that moves research and treatment of ED away from merely deriving symptomatic improvement in the disease to a proactive and comprehensive view that appreciates and attempts to reverse the underlying and concurrent vascular pathology.”

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