Effects of Viagra (Sildenafil) in Patients With Cardiovascular Disease

Effects of Viagra on Cardiovascular Diseases. The pharmaceutical preparation sildenafil citrate (Viagra) is being widely prescribed as a treatment for male impotence, a typical problem. Within the u. s. affects between 10 and 30 million men. The introduction of sildenafil has been a valuable contribution to the treatment of dysfunction. Which could be a relatively common occurrence in patients with upset. This text is written to appropriately caution and to not unduly alarm physicians in their use of sildenafil in patients with cardiovascular disease.

Reported cardiovascular side effects within the normal healthy population are typically minor and related to vasodilatation. However, although their incidence is tiny, serious cardiovascular events, including significant hypotension, can occur in certain populations in danger. Most in danger are individuals who are concurrently taking organic nitrates. Organic nitrate preparations are commonly prescribed to manage the symptoms of angina. The coadministration of nitrates and Viagra significantly increases the chance of probably life-threatening hypotension. Therefore, Viagra shouldn’t be prescribed to patients receiving any type of nitrate therapy.

Sildenafil (Viagra) Use for disfunction – Effects of Viagra on Cardiovascular Diseases.

Male impotence defined as “the inability to achieve and/or maintain penile erection sufficient for satisfactory sexual performance”. May be a common problem within the us affecting between 10 and 30 million men. 23 Sexual dysfunction in men after the diagnosis of arterial blood vessel disease or a MI is common. Most is thanks to fear that the exertion of sexual issues will precipitate another myocardial infarct. But 10% to fifteen is thanks to organic causes of impotence.4 Approximately 5.5 million men take nitrates on an everyday basis for a heart condition. Effects of Viagra on Cardiovascular Diseases. and another half 1,000,000 will experience a coronary failure annually. And are potential candidates for nitrate therapy.6 Sildenafil is potentially contraindicated in as many as 6 million patients.

Physiology of Erection

Penile erection is accomplished by engorgement of cavernous spaces within the corpora cavernosa under near-arterial pressures and involves dilation of arterial inflow, relaxation of corpora cavernosa smooth muscle, and constriction of venous outflow.12 The blood flow to the penis is supplied by the cavernosal arteries and their branches, the helicine arteries, which empty directly into the cavernous spaces.

Role of gas and cGMP

The relaxation of the penile arterial smooth muscle, the corporal smooth muscle, and thus erection is under the control of the autonomic systema nervosum.13 The principal neural mediator of penile smooth muscle relaxation is gas (NO).1314 NO and its derivatives have received much attention because they also account for the biological activity of the endothelium-derived relaxation factor and of organic and inorganic nitrate vasodilators.

Effects on Cardiac Contractility – Effects of Viagra on Cardiovascular Diseases.

AMP-specific PDE3 inhibitors (milrinone, vesnarinone, and enoximone) that increase long-term mortality in patients with heart disease,1719 sildenafil is extremely selective (>4000-fold) for human PDE5 over human PDE3 and has not been found to elevate cAMP (Pfizer, unpublished data). The cardiotoxic effects of PDE3 inhibitors are thought to be associated with increases in intracellular cAMP within the myocardium.151920 Furthermore, PDE5 isn’t present in cardiac myocytes, and sildenafil has been shown to possess no direct inotropic effects on dog trabeculae muscle (Pfizer, unpublished data). However, sildenafil has not been investigated extensively in failure patients.

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