During the 41-year period, 193 cardiovascular events (ie, coronary heart disease, stroke, and heart failure) occurred, 28 cardiovascular deaths occurred, and 138 total deaths occurred among the offspring.
The investigators found that, compared with adults whose mothers had not been overweight, offspring of overweight or obese mothers were at 90% higher risk of cardiovascular disease or death. Those offspring’s own risk factors, including obesity, diabetes, high blood pressure, and high cholesterol, appeared to account for some of that difference, said Dr. Mendelson. The results of this study support efforts to reduce obesity among young women before childbearing years, he added.
More than one-half of pregnant women in the US are overweight or obese, according to online statistics from the American Congress of Obstetricians and Gynecologists. Study participants were all Caucasian, said Dr. Mendelson. More research is needed to determine whether the findings apply to other racial or ethnic groups, he added. Additional larger studies in other populations also are needed to verify these findings. These results, however, contribute to a growing body of evidence linking maternal health to later-life cardiovascular health in the mothers’ children.
Early Detectable Vascular Disease May Be Linked to Erectile Dysfunction Men who have asymptomatic subclinical vascular disease are more likely to develop erectile dysfunction than are men who do not have early stage vascular disease, according to investigators.
“Erectile function can be a window into men’s cardiovascular and overall health,” said David I. Feldman, research assistant at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins in Baltimore, and lead author of the study. “Erectile dysfunction and cardiovascular disease commonly coexist.”
Researchers studied 1,862 men without existing heart disease and assessed the relationship between early atherosclerotic plaque development and arterial stiffness and dysfunction with their subsequent self-reporting of erectile dysfunction.
“We looked at which measurement of early vascular disease was the best predictor for erectile dysfunction,” said Mr. Feldman. “We also looked at whether those men with multiple abnormalities, such as increased plaque in addition to arterial stiffness and dysfunction, were more likely to also suffer from erectile dysfunction.”
The researchers found that men with coronary artery calcium scores greater than 100 Agatston units were 43% more likely to later self-report erectile dysfunction, compared with otherwise identical men with normal calcium scores. The Agatston Score is a measure of the amount of calcified plaque in the coronary arteries. Men who subsequently had erectile dysfunction were at least two times more likely to have coronary artery calcium scores greater than 100 Agatston units at the start of the study, which lasted more than nine years.
Although coronary artery calcium had the strongest association with erectile dysfunction, other measures of early vascular disease, including carotid intima-media thickness, were notably worse among men with erectile dysfunction, compared with men without erectile dysfunction. In addition, after considering age, race, sex, and traditional risk factors such as diabetes, smoking, high cholesterol, and obesity, men with abnormalities of atherosclerosis as well arterial stiffness and dysfunction were 53% more likely to later self-report erectile dysfunction.
To improve long-term erectile function and reduce the risk for worsening cardiovascular health, at-risk men should eat a heart-healthy diet, engage in physical activity, and avoid smoking, said Mr. Feldman.
“Current guidelines recommend exercise, stress testing, and an ankle-brachial index test for risk assessment in patients with erectile dysfunction. Our results suggest [that] a more powerful indicator is direct measurement of coronary plaque through the use of a coronary artery calcium test.”
More research is needed before physicians routinely use coronary artery calcium tests over other noninvasive methods to assess men’s sexual health, said Mr. Feldman. Furthermore, additional study is required on how best to prevent erectile dysfunction in men with confirmed vascular disease.
The investigators excluded men who were taking impotence drugs from the study. The investigators also could not ensure that all men were free of erectile dysfunction at the study’s baseline examination.