Viagra May Be Safe for Heart Patients

Thursday, January 19, 2012 9:07
Posted in category Men's Health

Impotence Drug Appears OK for Men Who Are Not Taking Nitrates

There have been reports of heart attacks and sudden death in men who took Viagra, Pfizer’s brand of the drug sildenafil. This drug is a usually effective remedy for impotence, or erectile dysfunction, but safety concerns have prevented some men from trying it. A new report in today’s New England Journal of Medicine may alleviate some of this fear, although there are still cautions that apply to Viagra’s use in some heart patients.

A group of investigators from the University of Pennsylvania, led by Howard Herrmann, M.D., studied the hemodynamic (blood flow and pressure) responses of 14 men who underwent coronary artery catheterization for severe vessel narrowing. Measurements were made before, and then one hour after the men took 100 milligrams of sildenafil citrate. The average age of the men studied was 61. They were in a stable condition at the time of the study; thus, those who were on nitrates were able to temporarily discontinue the use of such medication, which should not be used with sildenafil.

The variables measured included blood pressure, pressure within the coronary arteries, and flow rates in the diseased arteries, as well as in normal-appearing arteries in the same patients. Pressure studies and arterial blood flow measurements were also conducted within the heart chambers and in the great vessels leading from the heart to the lungs.

The 14 men studied had one severely narrowed vessel, with an average narrowing of 78 percent, or more than three-quarters occluded. The responses to sildenafil in the narrowed vessels were compared to the responses in the normal vessels, in those men who had an accessible normal vessel — 12 out of the 14.

The results were that there were no clinically significant differences in the pressure-flow measurements before and after sildenafil administration, although there was a slight decrease in total body and pulmonary (lung) arterial blood pressure after drug ingestion. And there was lower flow through the diseased (narrowed) vessels than there was through the normal ones, as was to be expected. However, the narrowed vessels did not respond any differently to sildenafil than did the normal coronary arteries.

Erectile dysfunction affects up to 30 million men in the United States, and is more common in those with heart disease. Thus, it is to be expected that some men taking Viagra, especially older men, would experience heart symptoms during sexual activity. There may also be some men who use the drug incorrectly, perhaps by taking it while using nitrates, which can cause serious interactions and even death.

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