Physiological or psychological impotence of erectile dysfunction, as clinically named, affects more than 18 million men in the United States aged over 20, as a research team from the Johns Hopkins Bloomberg School of Public Health announced.

The risk of erectile dysfunction was strongly connected to age, cardiovascular conditions, diabetes and a lack of physical activity.

Lifestyles characterized by intense physical activity and careful diet preventing cardiovascular disease and diabetes are important in preventing erectile dysfunction. "Physicians should be aggressive in screening and managing middle-aged and older patients for erectile dysfunction, especially among patients with diabetes or hypertension," said Elizabeth Selvin, PhD, MPH, lead author of the study and a faculty member in the Bloomberg School of Public Health's Department of Epidemiology. "The associations of erectile dysfunction with diabetes and cardiovascular risk factors may serve as powerful motivators for men who need to make changes in their diet and lifestyle."

The study was made on 2,126 volunteers involved in the National Health and Nutrition Examination Survey (NHANES). Men who stated being "sometimes able" or "never able" to get and keep an erection were ranked as suffering from erectile dysfunction, while those who declared being "always or almost always able" or "usually able" were not ranked in this category.

The statistical analysis revealed an 18 % of erectile dysfunction among men in the United States. Males over 70 were the most vulnerable category to erectile dysfunction while only 5 % of those aged 20 and 40 were impotent. Amongst the diabetes patients, almost half presented erectile dysfunction.

Overall, in almost 90 % of men with erectile dysfunction, the condition was associated with at least one risk factor for cardiovascular condition, including diabetes, hypertension, high cholesterol levels or smoking. Impotent males were also less likely to have made an intense physical activity within the month previous to the research.