Background: Accumulating evidence suggests that erectile dysfunction (ED) may be an early manifestation of generalized vascular disease. Aortic stiffness is an independent marker and prognosticator of cardiovascular risk. The association of ED with aortic stiffness has not been defined.

Methods: A total of 164 men (mean age 59±9 yrs) affected by non-psychogenic and non-hormonal erectile dysfunction for more than 6 months were studied. All participants were invited to complete a 5-item form of the International Index of Erectile Function (IIEF-5) which is a validated and widely applied method for the evaluation of ED. ED was defined as mild (SHIM score 17–21), mild to moderate (11–16), moderate (8–10) and severe (7 or less). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness using an automated non-invasive device (Compliorqa^®).

Results: There was a stepwise increase in PWV from mild ED, to mildmoderate and moderate ED and to severe ED (p < 0.001, figure). In univariate analysis, a negative correlation between PWV and IIEF-5 score was observed (r = −0.37, p < 0.001). Moreover, in separate backward elimination multiple regression model, PWV was significantly associated with IIEF-5 score (b=-0.223, P = 0.006, R2 = 0.41), after controlling for age, body-mass index, mean pressure, cholesterol, triglycerides, C-reactive protein, hypertension, diabetes, history of smoking, antihypertensive agents and statines.

Conclusions: ED is associated with impaired aortic elastic properties. This finding provides further evidence for the potential link between ED and cardiovascular risk.