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style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After excluding participants taking <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> medications at baseline, we studied 1862 men age 45 to 84 years free of known cardiovascular disease from the Multi\u2010Ethnic Study of Atherosclerosis (<jats:styled-content style=\"fixed-case\">MESA<\/jats:styled-content>) with comprehensive baseline subclinical vascular disease phenotyping and <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> status assessed at <jats:styled-content style=\"fixed-case\">MESA<\/jats:styled-content> visit 5 (9.4 \u00b1 0.5 years after baseline) using a standardized question on <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> symptoms. Multivariable logistic regression was used to assess the associations between baseline measures of vascular disease (atherosclerosis domain: <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>, carotid intima\u2010media thickness, carotid plaque, ankle\u2010brachial index; vascular stiffness\/function domain: aortic stiffness, carotid stiffness, brachial flow\u2010mediated dilation) and <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> symptoms at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean baseline age was 59.5 \u00b1 9 years, and 839 participants (45%) reported <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> symptoms at follow\u2010up. Compared with symptom\u2010free individuals, participants with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> had higher baseline prevalence of <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> score &gt;100 (36.4% vs 17.2%), carotid intima\u2010media thickness <jats:italic>Z<\/jats:italic> score &gt;75th percentile (35.3% vs 16.6%), carotid plaque score \u22652 (39% vs 21.1%), carotid distensibility &lt;25th percentile (34.6% vs 17.1%), aortic distensibility &lt;25th percentile (34.2% vs 18.7%), and brachial flow\u2010mediated dilation &lt;25th percentile (28.4% vs 21.3%); all <jats:italic>P<\/jats:italic> &lt; 0.01. Only <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> &gt;100 (odds ratio: 1.43, 95% confidence interval: 1.09\u20101.88) and carotid plaque score \u22652 (odds ratio: 1.33, 95% confidence interval: 1.02\u20101.73) were significantly associated with <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Subclinical vascular disease is common in men who later self\u2010report <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>. Early detection of subclinical atherosclerosis, particularly advanced <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> and carotid plaque, may provide opportunities for predicting the onset of subsequent vascular <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22530","type":"journal-article","created":{"date-parts":[[2016,5,4]],"date-time":"2016-05-04T15:05:07Z","timestamp":1462374307000},"page":"291-298","source":"Crossref","is-referenced-by-count":41,"title":["Subclinical Vascular Disease and Subsequent Erectile Dysfunction: The Multiethnic Study of Atherosclerosis (<scp>MESA<\/scp>)"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7678","authenticated-orcid":false,"given":"David I.","family":"Feldman","sequence":"first","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medical Institutions  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Cainzos\u2010Achirica","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medical Institutions  Baltimore Maryland"},{"name":"Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L.","family":"Billups","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medical Institutions  Baltimore Maryland"},{"name":"The James Buchanan Brady Urological Institute The Johns Hopkins Hospital  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"DeFilippis","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medical Institutions  Baltimore 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