Yannas Dr. Dimitri, Zago Dr. Elena, Cavallini Dr. Elena, Todisco Dr. Tommaso, Vignozzi Prof. Linda, Corona Dr. Giovanni, Maggi Prof. Mario, Rastrelli Prof. Giulia

(253) EDUCATION DEGREE PREDICTS CARDIOVASCULAR OUTCOMES IN MEN SUFFERING FROM ERECTILE DYSFUNCTION

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health

Abstract Objectives The level of education has been recognized as a cardiovascular (CV) risk factor; nevertheless, it is often neglected in CV risk prediction. To evaluate the psychobiological correlates of the level of education and if it could predict incident major adverse CV events (MACE) in men consulting for erectile dysfunction (ED). Methods 3733 men (49.8±13.7 years old) attending an andrology outpatient clinic for ED were studied. Sexual and psychological symptoms, hormonal and metabolic as well as instrumental (penile color Doppler ultrasound; PCDU) parameters were evaluated according to the education level (university, upper secondary, lower secondary, and primary degree). For a subset of 956 patients data on incident MACE were retrospectively collected for 3.9±2.4 years. Results As compared with men with university degree, those with a lower education had an increased frequency of moderate-severe ED (OR=1.21 [0.99;1.48], 1.41 [1.14;1.73], 1.70 [1.26;2.30] for upper secondary, lower secondary and primary school, respectively) and reduced flaccid peak systolic velocity at PCDU. Men with a lower level of education had a worse a greater probability of suffering from metabolic syndrome (OR=1.38 [1.06;1.79], 1.73 [1.34;2.24], 1.72 [1.24;2.37] for upper secondary, lower secondary and primary school, respectively) and were more likely to have history of previous CV events. In the longitudinal study, men with higher level of education had a significantly lower incidence of MACEs. The role of higher education as an independent predictor of MACE was established by multivariable Cox regressions (HR=2.14 [1.24-3.69]). Conclusions In ED subjects, lower level of education is associated with a more severely impaired erectile function with atherogenic pathogenesis and with a worse cardio-metabolic profile. In addition, a lower level of education predicts forthcoming MACEs. Therefore, education level should be considered as a costless but valuable information in the assessment of CV risk in patients with ED. Conflicts of Interest none

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