Emma Heeley

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Emma Heeley
Possible ideas for what cardiovascular questions
to study in the 45 and up study?
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Unique angle

• Q37 How often are you able to get and keep an
  erection that is firm enough for satisfactory
  sexual activity?
• Currently 20 of males in 45 and up study report
  Erectile Dysfunction (Never)
• Approx 25,000 males with ED in final cohort

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1st idea Are PDE5 inhibitors cardioprotective?

• Phosphodiesterase (PDE) 5 inhibitors are
  vasodilatory.
• Some laboratory evidence to suggest more
  long-term effects.

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Possible study (1)

• Exposure PDE5s not listed on PBS, only on
  veterans.
• Outcome major CVE link to hospital records
  using CHeRel

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2nd ideaIs ED an early warning sign for CVD?

• Erectile dysfunction appears to be one of the
  earliest signs of systemic vascular disease and
  might be considered as an early marker for
  subclinical cardiovascular disease.

Curr Opin Urol. 2006 Nov16(6)435-43
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Possible study (2)

• Nested case control study
• Cases - ED patients with no CVD
• Controls non ED patients with no CVD
• Matching variables Age, SES, pre-existing
  diseases?
• Outcome treatments for CVD (PBS) or admission
  into hospital for CVE (CHeRel)

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3rd ideaWhat factors are associated with ED?

• Physical disease and disorders
• Surgery or trauma
• Medications
• Substance abuse
• Stress, anxiety or depression

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Possible study (3)

• Predictive model using factors in 45 and up
  questionnaire.

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Any thoughts?