Viagra may prolong life for men with coronary artery disease

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Taking Viagra does more than improve men’s performance in bed – it may also help those with coronary artery disease live longer and have a lower risk of experiencing a new heart attack, according to a new study.

“Potency problems are common in older men and now our study also shows that PDE5 inhibitors may protect against heart attack and prolong life,” said study lead author Martin Holzmann, an adjunct professor of medicine at the Karolinska Institute in Stockholm.

Impotence, also known as erectile dysfunction, may be linked to impaired blood flow — and can be an early warning sign of heart disease in healthy men, the authors noted.

ED can be treated either locally with the injected drug alprostadil, which dilates the blood vessels, or with drugs known as PDE5 inhibitors, which include the little blue pills and Cialis, according to Health Day.

Holzmann’s team compared the effect of alprostadil and PDE5 inhibitors among 18,500 men who had already suffered a heart attack or had undergone a procedure such as bypass or angioplasty, and were diagnosed with what’s known as “stable” coronary artery disease.

“The risk of a new heart attack is greatest during the first six months (after such interventions), after which we consider the coronary artery disease to be stable,” Holzmann wrote.

The subjects began taking some form of erectile dysfunction drug at least six months after their heart attack or heart procedure. About 16,500 of the men took Viagra, Cialis or some other PDE5 drug, while the others took injected alprostadil.

The researchers followed the men’s health for an average of almost six years, during which time about 2,800 of them died.

Those taking a PDE5 drug had a 12 percent lower risk of dying during that follow-up than men who took alprostadil, the team reported in the Journal of the American College of Cardiology.

Men taking a PDE5 drug also had a lower risk of a new heart attack, heart failure or the need for an angioplasty or bypass procedure than those who got alprostadil, according to the report, which had no drug industry funding.

The protection was dose-dependent, meaning that the more frequently a man used a PDE5 inhibitor, the lower his risk.

Holzmann cautioned that the study wasn’t designed to prove a cause-and-effect relationship, saying other factors could be at play.

“It is possible that those who received PDE5 inhibitors were healthier than those on alprostadil and therefore had a lower risk [of heart issues],” he said as an example.

“To ascertain whether it is the drug that reduces the risk, we would need to randomly assign patients to two groups, one that takes PDE5 and one that doesn’t. The results we have now give us very good reason to embark on such a study,” Holzmann added.

Two experts in the United States who weren’t connected to the study said the findings are intriguing, but stressed that more study is required.

PDE5 drugs “are ‘vasoactive,’ meaning they have an effect on the blood vessels making them less stiff, and able to vasodilate,” Dr. Guy Mintz, director of cardiovascular health at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, NY, told Health Day.

“These agents may also have anti-inflammatory effects,” he said, stressing
that “this is not a therapy for all patients with coronary artery disease — only those that have impotence as well.”

He added: “There is a need to do follow-up studies to see if PDE5 inhibitors are directly responsible for the beneficial effects, or is the benefit due to having a partner (not being lonely), an active sex life (exercise), or a happier approach to life (a sense of well-being).”

Dr. Michael Goyfman, who directs clinical cardiology at Long Island Jewish Forest Hills, agreed that the Swedish findings are only useful to generate theories for now, not to change medical practice.

He suggested that the better outcomes for men taking a PDE5 were based on their underlying health — perhaps only the sicker ones got alprostadil — or income, because those better-off could afford the ED drugs.

“While the study is interesting, it would not change practice until further, randomized controlled trials are performed,” Goyfman said.

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