Introduction: Erectile dysfunction may be an early sign of atherosclerosis. The incidence of erectile dysfunction is increased in patients with cardiovascular risk factors, such as hypertension and diabetes mellitus. However, the effect of glucose metabolism on the incidence of erectile dysfunction in hypertensive subjects has not been defined.

Methods: We studied 255 consecutive male subjects (age 52 ± 11 years) with never-treated uncomplicated hypertension. The study population was divided into three groups according to glucose metabolism: i) type-II diabetes mellitus (DM) 13 patients, age 58 ± 13 years, ii) impaired glucose tolerance (IGT) 51 patients, age 55 ± 10 years, and iii) normal glucose metabolism (NGM) 191 patients, age 50 ± 11 years. Erectile dysfunction diagnosis and score were evaluated according to the International Index of Erectile Function (IIEF) questionnaire.

Results: Patients with DM had decreased IIEF score compared to NGM patients (16.9 ± 6.6 vs. 20.2 ± 5.1, p<0.01). Patients with IGT had also decreased IIEF score compared to NGM patients (17.0 ± 6.9 vs. 20.2 ± 5.1, p<0.01). When patients with DM were compared to patients with IGT no difference was observed in IIEF score.

Conclusions: Not only diabetes mellitus, but also impaired glucose tolerance is associated with erectile dysfunction, i.e. an early sign of atherosclerosis, in hypertensives.