Assessing the influence of cardiovascular risk factors on the severity of erectile dysfunction: a multivariate statistical analysis

Introduction. The American Heart Association identifies 7 major factors that affect the condition of the vascular wall: smoking, blood pressure, total cholesterol, glucose, body mass index, physical activity, and diet. The vascular wall lesions most often manifest clinically as vasculogenic erectile dysfunction (ED). consequently, evaluating patients for the presence of the above risk factors can not only help in the treatment of ED, but can also significantly increase the chances of early detection of cardiac pathology. Objective. To assess cardiovascular disorder markers' role in prognosing of the presence or absence of ED and its severity. Materials and methods. The study included 40 patients aged 33 - 60 years. Erectile function was assessed using the device «Androscan - MIT» («Minimally invasive technologies» LLc, Moscow, Russian Federation) and the IIEF-15 questionnaire. Statistical data processing was carried out using Statistica 12 («StatSoft Inc.», Tusla, cA, USA) и IBM® SPSS Statistics 26 («SPSS: An IBM company», IBM SPSS corp., Armonk, Ny, USA). Results. For patients with more severe ED, a greater deviation of the parameters studied from normal is typical. The most significant impact on the detection of different ED degrees using the device «Androscan - MIT» had Tc, HDL, LDL, RP, BMI, triglycerides и HbA1c levels. Based on the androscanning data, a classification tree with two branches (branching conditions - the level of Tc and LDL) and four terminal vertices (depending on the degree of ED) was obtained. There were no classification errors predicting ED degrees, which in this case indicates the good significance of the mathematical prediction. Only IIEF-15 scores had the greatest impact on ED detection using IIEF-15. The only condition for branching when constructing classification trees was the number of IIEF-15 points (two branches with three terminal vertices were obtained). Conclusion. cardiovascular risk factors are predictors of vascular ED, detected by androscanning, while the widespread IIEF-15 questionnaire remains completely dependent on subjective feelings of patients without relying on laboratory and instrumental research methods.