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Causal associations between erectile dysfunction and high blood pressure, negative psychology: a Mendelian randomization study

  • Zhou Sun1,†
  • Jun Hu2,†
  • Yanping Luo3,†
  • Hui Shu1
  • Zheqi Fan1
  • Songtao Shuang1
  • Pan Lu1
  • Bang Xiao1
  • Zhuo Wei1,*,

1Department of Urology, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, 432000 Xiaogan, Hubei, China

2Department of Health Management Research Center, The First People’s Hospital of Jiangxia District, 430200 Wuhan, Hubei, China

3Department of Cardiovascular, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, 432000 Xiaogan, Hubei, China

DOI: 10.22514/jomh.2023.084 Vol.19,Issue 9,September 2023 pp.36-58

Submitted: 27 February 2023 Accepted: 11 April 2023

Published: 30 September 2023

*Corresponding Author(s): Zhuo Wei E-mail:

† These authors contributed equally.


Erectile dysfunction (ED) has been closely associated with both high blood pressure (HBP) and psychological traits, but the causal relationship between them remains unclear. Herein, we aimed to identify the causal risk factors for ED. We conducted univariable and multivariable Mendelian randomization (MR) analyses using genetic variants associated with metabolic syndrome and psychology traits at the genome-wide significance (p < 5 × 10−8) level obtained from corresponding genome-wide association studies. We used summary-level statistical data for ED from the European Bioinformatics Institute (EBI) database of complete Genome-Wide Association Studies (GWAS) summary data. We also conducted reverse causality and performed power calculations for MR. Our results showed that HBP was associated with increased odds of ED (odds ratio (OR) = 1.66 (95% confidence interval (CI), 1.13–2.45), a p-value for the inverse variance-weighted method (PIVW ) = 1.06 × 10−2, Power = 100%), as were myocardial infarction (OR = 1.09 (95% CI, 1.02–1.17), PIVW = 1.18 × 10−2, Power = 56%) and ischemic stroke (OR = 1.21 (95% CI, 1.02–1.43), PIVW = 2.87 × 10−2, Power = 10%). In terms of psychological traits, irritable mood (OR = 1.86 (95% CI, 1.14–3.02), PIVW = 1.30 × 10−2, Power = 96%) and neuroticism (OR = 1.36 (95% CI, 1.04–1.79), PIVW = 2.66 × 10−2, Power = 80%) were associated with increased odds of ED. Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) showed no evidence of pleiotropic bias, and sensitivity analyses confirmed the robustness of our results. We have established a causal link between HBP and ED, and we have also found evidence suggesting a causal relationship between irritable mood and ED.


Erectile dysfunction; High blood pressure; Negative psychology; Single-nucleotide polymorphisms; Mendelian randomization

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Zhou Sun,Jun Hu,Yanping Luo,Hui Shu,Zheqi Fan,Songtao Shuang,Pan Lu,Bang Xiao,Zhuo Wei. Causal associations between erectile dysfunction and high blood pressure, negative psychology: a Mendelian randomization study. Journal of Men's Health. 2023. 19(9);36-58.


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