Incidence of erectile dysfunction and characteristics of patients before and after the introduction of sildenafil in the United Kingdom: cross sectional study with comparison patients

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Abstract
Subjects, methods, and results We used data up to April 2001 from 272 practices contributing to the UK general practice research database. 3 4 Cases were men aged 40–79 years with at least two years of recorded medical history who had a first time diagnosis of erectile dysfunction that was recorded between January 1990 and December 2000. We compared cases before (January 1990 to August 1998) and after (September 1998 to December 2000) the introduction of sildenafil. We matched cases with comparison patients who had no recorded diagnosis of erectile dysfunction. Comparison patients were matched to the cases in a ratio of 5:1 by sex, year of birth, general practice, and date of diagnosis. We calculated a prevalence ratio for various conditions by dividing the prevalence of the condition at the time of first diagnosis of erectile dysfunction by the prevalence among the comparison patients. We identified 10 371 first time recorded cases of erectile dysfunction for an estimated 2.3 million man years of observation. The annual incidence of erectile dysfunction increased gradually during the mid-1990s then rose twofold to threefold during the years 1998 to 2000 (figure). The increase occurred in all age groups (40-49, 50-59, 60-69, and 70–79 years). View larger version: In this window In a new window Annual incidence (95% confidence intervals) of erectile dysfunction among men aged 40-79, before and after introduction of sildenafil in 1998 in the United Kingdom The prevalence of ischaemic heart disease among men with erectile dysfunction decreased from 15.7% to 11.3% after sildenafil was introduced, and the prevalence ratio decreased from 1.51 (95% confidence interval 1.42 to 1.61) to 0.89 (0.81 to 0.99) (see table A on bmj.com). Current nitrate use also decreased. Prevalence ratios were even lower for men who were prescribed sildenafil (table B on bmj.com). The prevalence ratios for diabetes, hypertension, hyperlipidaemia, and smoking changed less or did not change significantly.