{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:57:56Z","timestamp":1771916276003,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T00:00:00Z","timestamp":1502668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Vascular erectile dysfunction (ED) has been identified as a potentially useful risk factor for predicting future cardiovascular events, particularly in younger men. Because these men typically score more favorably on traditional cardiovascular disease risk assessment tools, there exists a gap in knowledge for how to most appropriately identify those men who would benefit from more aggressive treatments. To date, no studies have examined the impact of fitness on cardiovascular outcomes in men with ED. This study sought to examine the prognostic impact of maximal exercise capacity on cardiovascular\u2010related outcomes in men ages 40 to 60\u2009years being treated for ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We hypothesized that there would be an independent association between higher baseline fitness level and lower cardiovascular events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 1152 men with pharmacy claims file\u2013confirmed active pharmacologic treatment for ED from the Henry Ford Exercise Testing (FIT) Project (1991\u20132009). All patients were free of coronary heart disease and heart failure, and underwent clinician\u2010referred exercise stress testing, with fitness measured in metabolic equivalents of task (METs). Multivariable Cox proportional hazard models adjusted for traditional cardiovascular risk factors were used to study the association between fitness and all\u2010cause mortality, major adverse cardiovascular events (MACE) (defined as myocardial infarction or revascularization), and incident type 2 diabetes mellitus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the population was 53\u2009years, with 39% African Americans. In multivariable analysis, each 1 MET of fitness was associated with a 16% lower risk of death (hazard ratio [HR]: 0.84, 95% confidence interval [CI]: 0.76\u20100.94, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), and a nonsignificant reduction in MACE (HR: 0.89, 95% CI: 0.79\u20101.003, <jats:italic>P<\/jats:italic>\u2009=\u20090.048), and incident diabetes (HR: 0.92, 95% CI: 0.85\u20101.01, <jats:italic>P<\/jats:italic>\u2009=\u20090.129).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher baseline fitness is associated with improved cardiovascular prognosis in a population of middle\u2010aged men treated for ED.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22768","type":"journal-article","created":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T14:42:35Z","timestamp":1502721755000},"page":"1049-1054","source":"Crossref","is-referenced-by-count":8,"title":["Prognostic value of exercise capacity among men undergoing pharmacologic treatment for erectile dysfunction: The FIT Project"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-2442","authenticated-orcid":false,"given":"Robert V.","family":"Same","sequence":"first","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medicine  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Al Rifai","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medicine  Baltimore Maryland"},{"name":"Department of Medicine University of Kansas School of Medicine  Wichita Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7678","authenticated-orcid":false,"given":"David I","family":"Feldman","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medicine  Baltimore Maryland"},{"name":"University of Miami Miller School of Medicine  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin L.","family":"Billups","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medicine  Baltimore Maryland"},{"name":"Johns Hopkins Brady Urologic Institute Johns Hopkins Medicine  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clinton A.","family":"Brawner","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeina A.","family":"Dardari","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Medicine  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan K.","family":"Ehrman","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Keteyian","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mouaz H.","family":"Al\u2010Mallah","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Henry Ford Hospital  Detroit Michigan"},{"name":"King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center Ministry of National Guard, Health Affairs  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Blaha","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart 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