ORIGINAL ARTICLE The prevalence of erectile dysfunction in heart failure patients by race and ethnicity K Hebert 1 , B Lopez 1 , J Castellanos 2 , A Palacio 3,4 , L Tamariz 3,4 and LM Arcement 5 1 Division of Cardiology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA; 2 Division of Internal Medicine, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA; 3 Humana Health Services Research Center, Department of Medicine, University of Miami, Miami, FL, USA; 4 Veterans Affairs Medical Center, Department of Medicine, Miami, FL, USA and 5 Leonard J Chabert Medical Center, Department of Medicine, Houma, LA, USA Erectile dysfunction (ED) is a common problem in male patients with heart failure (HF). However, no study was found that estimates the prevalence of ED by US ethnic groups with HF. We conducted an observational, cross-sectional study of patients enrolled in a HF disease management program in two sites Louisiana (N ¼ 329; 178 white, 99 black) and Florida (N ¼ 52; Hispanic). All male patients with an ejection fraction p40% were included. The Sexual Health Inventory for Men was used to estimate the prevalence of ED. Overall prevalence of ED was 89% and ED severity did not vary by race/ethnic group. Race/ethnic group differences were found for age, New York Heart Association functional classification, and blood pressure. Hispanic patients had the lowest unadjusted and adjusted prevalence rate of ED (81, 85%) compared to Black (90, 95%) and White (91, 92%) patients. There is a high prevalence of ED in Hispanic, Black and White ethnic groups with HF. International Journal of Impotence Research (2008) 20, 507–511; doi:10.1038/ijir.2008.35; published online 14 August 2008 Keywords: heart failure; erectile dysfunction; Hispanic Americans; African Americans Introduction Erectile dysfunction (ED) is defined as the consis- tent inability to attain or maintain a penile erection of sufficient quality to permit satisfactory sexual intercourse. 1 The prevalence rate of ED in the general population has been shown to vary across countries and race/ethnicity 2,3 and increase with age. 4,5 In the Men’s Attitudes to Life Events and Sexuality study, which included men from eight countries (United States, United Kingdom, Germany, France, Italy, Spain, Mexico and Brazil) aged 20–75 years ED prevalence ranged from 22% in the United States to 10% in Spain. 2 However, in another population study in Brazil, Italy, Japan and Malaysia the age-adjusted prevalence of ED was 34% in Japan, 22% in Malaysia, 17% in Italy and 15% in Brazil. 6 Regarding race/ethnic differences in the United States, results have been inconsistent. Results from a recent survey among male patients aged 40 or older reported that the prevalence of ED was 21.9% in white, 24.4% in Black and 19.9% in the Hispanic population. 5 In contrast, results from the National Health and Nutrition Examination Survey of men aged 20 years old and above indicated Hispanic ethnicity was associated with elevated risk for ED compared with black and white men. 3 In addition to age, which has been found to be the strongest predictor of ED in the general population, several other factors such as heart disease have also been found to be associated with ED. 4–6 Not surprisingly, the prevalence of ED is higher in patients with heart disease and has been found to range between 42 and 75%. 7–10 When ED is examined in patients with heart failure (HF) the prevalence grows to 84%. 11 The alarming high prevalence of ED among HF patients coupled with the increasing rates of congestive HF in industria- lized nations suggests that ED is an important medical concern in patients with congestive HF. Although reports on the prevalence of ED in HF patients have begun to appear in the literature, little is known regarding the prevalence of ED in Received 16 May 2008; revised 26 June 2008; accepted 11 July 2008; published online 14 August 2008 Correspondence: Dr B Lopez, Division of Cardiology, Department of Medicine, Miller School of Medicine, University of Miami, Jackson Memorial Hospital North Wing 210, 1611 NW 12th Avenue, Miami, FL 33136, USA. E-mail: blopez21@bellsouth.net International Journal of Impotence Research (2008) 20, 507–511 & 2008 Nature Publishing Group All rights reserved 0955-9930/08 $30.00 www.nature.com/ijir