Treatments to improve sexual performance increase the risk of death when combined with medications for angina.
- Phosphodiesterase type 5 inhibitors (PDE5i) are prescribed to combat erectile dysfunction. Nitrate medications are indicated to treat chest pain.
- Use of PDE5i in combination with nitrate medication in men with coronary heart disease may have an increased risk of cardiovascular morbidity and mortality.
- Careful consideration should be given to the patient’s situation before prescribing these erectile dysfunction treatments to men with cardiovascular disease who are taking nitrates.
“Doctors are seeing an increase in requests for erectile dysfunction medications from men with cardiovascular disease. Although this is associated with lower mortality compared to no treatment after a myocardial infarction, “Patients taking nitrate medications may be at increased risk of negative health effects.” This was recently reported Daniel Peter Anderssonprofessor at Karolinska University Hospital in Stockholm (Sweden).
5,710 men were taking medication for erectile dysfunction and chest pain
In a study, the researcher and his team wanted to examine the link between phosphodiesterase type 5 inhibitors (PDE5i), which are sold under the names Viagra, Levitra or Cialis, and cardiovascular outcomes in men suffering from coronary heart disease treated with nitrate-based drugs. As a reminder, these treatments are prescribed to relieve angina, that is to say chest pain occurring behind the sternum.
For the purposes of the work, the scientists used Swedish registers. They included 61,487 men with a history of myocardial infarction or percutaneous coronary intervention who received two prescriptions for nitrate medications within six months. Exposure was defined as having received at least two prescriptions for phosphodiesterase type 5 inhibitors.
Among participants, 55,777 took nitrate-based medications and 5,710 took both nitrates and PDE5i. Nitrate users were followed for approximately six years and consumers of nitrates and phosphodiesterase type 5 inhibitors for three years. “We performed multivariable risk regression for various health outcomes, including all-cause mortality, cardiovascular and non-cardiovascular mortality, myocardial infarction (MI), heart failure, cardiac revascularization, and events major cardiovascular diseases”, specified the authors.
The combination of nitrates and PDE5i is associated with an increased risk of death
According to the results, published in the journal Journal of the American College of Cardiology, combined use of PDE5i and nitrates is associated with higher risk for all health outcomes compared to those taking nitrates alone. In people taking both phosphodiesterase type 5 inhibitors and nitrates, few events occurred 28 days after PDE5i delivery, with lower incidence rates than in men taking nitrates, which indicates that the immediate risk of an event is low.
“Our aim is to highlight the need for careful consideration centered on the patient’s situation before prescribing phosphodiesterase type 5 inhibitors to men receiving nitrate treatment. Furthermore, it justifies our efforts to continue research on the ambiguous effects of erectile dysfunction drugs on people with cardiovascular disease”, concluded Daniel Peter Andersson.
