BURDEN OF ERECTILE DYSFUNCTION AMONG HEART FAILURE PATIENTS IN A CENTRE IN THE SOUTH-WESTERN NIGERIA: A PILOT STUDY

O. Adebayo1, A. Aje1, O.S. Ogah2, A. Adebiyi2, A.M. Adeoye2, O. Oladapo2

  1. Department of Medicine, University College Hospital, Ibadan, Nigeria.
  2. Department of Medicine, University College Hospital, Ibadan, Nigeria/Department of Medicine, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Nigeria.

Abstract

Background: Erectile dysfunction (ED) is a common problem among heart failure (HF) patients but is usually ignored in busy clinics in developing countries like Nigeria. Evidence abound that it has a great impact on the quality of life, survival, and prognosis of HF patients.

Objective: This study sought to evaluate the burden of ED among HF patients at the University College Hospital, Ibadan.

Methods: This pilot cross-sectional study was conducted in the Cardiology clinic of the Medical Outpatient Unit of the Department of Medicine, University College Hospital, Ibadan. Consenting male patients with chronic HF were consecutively recruited into the study between June 2017 and March 2018. The International Index of Erectile Function-version five (IIFE-5) was used to access the presence and degree of ED. Statistical analysis was done with SPSS version 23.

Results: A total of 98 patients were recruited with a mean± standard deviation (SD) age of 57.6 ±13.3 years, and age range of 20–88 years. The majority of the participants were married (78.6%), and the mean ± SD duration of HF diagnosis was 3.7 ±4.6years. The overall frequency of ED was 76.5%, and those with previous self-reported ED were 21.4%. Mild erectile dysfunction, mild to moderate erectile dysfunction, moderate erectile dysfunction, and severe erectile dysfunction were present in 24(24.5%), 28(28.6%), 14(14.3%), and 9(9.2%) respectively.

Conclusion: Erectile dysfunction is common among chronic heart failure patients in Ibadan. Therefore, adequate attention is needed for this sexual health issue among males with heart failure to improve their quality of care.

Keywords: Erectile function, Epidemiology, Erectile dysfunction, Heart failure, Cardiovascular disease

Correspondence:

Dr. O. Adebayo
Department of Medicine,
University College Hospital, Ibadan,
Nigeria
E-mail: doctorladi@yahoo.com
Date of Acceptance: 31st Dec., 2022

Introduction

Erection in human males is primarily a vascular event elicited by psychological, vascular, hormonal, and neurologic factors.1 Erectile dysfunction, on the other hand, is the inability to achieve and maintain an erection sufficiently to permit satisfactory sexual intercourse.2 While there are multiple pathogenic pathways in heart failure affecting human erectile function, the commonest pathways appear to be the vasculogenic pathway and drug-induced, while psychogenic plays a lesser role.2 Hormonal and neurogenic pathways appear to play little role in pathobiology of ED in heart failure.2

Furthermore, heart failure (HF) and erectile dysfunction (ED) share similar risk factors such as hypertension, age, diabetes mellitus, and coronary artery disease.1,3 In addition, physiologic complications of HF create unique organic and psychological factors, which contribute to ED in this patient population.1 Finally, standard HF therapy such as beta-receptor blockers, digoxin, and thiazide diuretics are identified as culprits for ED among HF patients.4 Regardless of the cause of the HF, all of the aforementioned factors make ED extremely common among HF patients.1,3,5

This dysfunction has been found to herald cardiac disease, in as much as 42% to 75% of coronary artery disease patients.1,3,5 The high burden of ED has severe implications for HF patients’ quality of life.6 The dysfunction has also been identified as a complication of HF.7 In addition, the comorbid state of EDcoexisting with HF confers a serious clinical challenge to the healthcare team. Unfortunately, there are few studies that have assessed the burden among the black population, and this is even worse among the Nigerian HF population, even though, previous studies among general population of Nigerians with different cardiovascular diseases or risk factors have observed a high burden of ED.8,9 Furthermore, the burden of HF is high and appears to be on the increase, as is the associated burden of erectile dysfunction.

This study sought to assess the burden of ED among chronic HF population attending the University College Hospital, Ibadan.