Erectile dysfunction (ED) is now recognized in most cases to be of vascular cause, with endothelial dysfunction as the main pathophysiological mechanism. Studies nowadays are suggesting that ED is often a marker for an asymptomatic cardiovascular disease (CVD) and that the two conditions oftenly coexist.

The aim of this study was to evaluate the link between different cardiovascular risk scores and the severity of erectile dysfunction, and to identify the most related risk factors.

This was a prospective observational study carried out from June 2020 to March 2022, including all patients with organic erectile dysfunction referred to our cardiology consultation from the department of urology. The severity of ED was evaluated using the International Index of Erectile Function (IIEF5). The cardiovascular risk was assessed through identifying the different risk factors and using the SCORE2 and GLOBORISK algorithms.

We included 109 patients with a mean age of 59 years±7.9. Cardiovascular risk factors were (%): Body mass index (BMI) greater than 25 kg/m2 (68.5), followed by smoking (56.9), diabetes mellitus (53.2), arterial hypertension (52.3), and dyslipidemia (44%). The severity of erectile dysfunction was mild in 10.1%, moderate in 46.8% and severe in 42.2% of the cases. One third of the patients (33%) with severe ED had a history of coronary artery disease confirmed by angiography. When analyzing each cardiovascular risk factor apart, only dyslipidemia showed a statistical correlation with the severity of ED (OR=2.4, IC95% [1.13–5.47]; P=0.02). However, using the SCORE2 and GLOBORISK algorithms to evaluate the risk of CVD, both showed a statistically significant relationship with the severity of ED (P=0.02 and 0.04, respectively).

The assessment of the risk of cardiovascular disease in patients with erectile dysfunction should be based on valid dedicated scores rather than analyzing each cardiovascular risk factor apart.