Could Viagra Help Men With Heart Disease Live Longer? | Health Info

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By Ernie Mundell and Cara Murez Health Day Journalists

(Health day)

TUESDAY, March 23, 2021 (HealthDay News) – These little blue pills were designed to help men with impotence. But Viagra and similar drugs could also reduce the risk of dying or having another heart attack in men with heart disease, according to a new Swedish study.

“Potency issues are common in older men and now our study also shows that PDE5 inhibitors can protect against heart attacks and prolong life,” said lead author of the study Martin Holzmann. . He is Assistant Professor of Medicine at the Karolinska Institute in Stockholm.

As the study authors noted, impotence (also known as erectile dysfunction) may be linked to impaired blood flow and therefore may be a warning sign of heart disease in healthy men. health. It can be treated either topically with the injected drug alprostadil (which dilates blood vessels) or with widely used drugs known as PDE5 inhibitors, which include pills such as Viagra and Cialis.

In the new study, Holzmann’s group compared the effect of alprostadil and PDE5 inhibitors in a group of 18,500 men who had previously had a heart attack and / or had undergone a procedure such as bypass surgery. or angioplasty, and who had been diagnosed with “stable” coronary artery disease.

“The risk of a new heart attack is greatest in the first six months [after such interventions]”, explained Holzmann in a press release from the institute,” after which we consider the coronary heart disease to be stable “.

The men in the study started taking some form of erectile dysfunction medicine at least six months after their heart attack or heart procedure. Most of the men (around 16,500) took Cialis, Viagra or another PDE5 drug, while the rest took alprostadil by injection. The researchers then followed the men’s health for an average of almost six years, during which time about 2,800 men died.

Men taking a PDE5 drug had a 12% lower risk of death during this follow-up than men taking alprostadil, the Swedish team reported on March 22 in the Journal of the American College of Cardiology.

Men taking a PDE5 drug also had a lower risk of having a new heart attack, heart failure, or needing angioplasty or bypass surgery than those who received alprostadil. The protection was dose-dependent, which means that the more frequent the use of a PDE5 inhibitor, the lower the risk to humans.

Still Holzmann pointed out that the study was not designed to prove a cause-and-effect relationship and that other factors might be at play.

For example, “It is possible that those who received PDE5 inhibitors are in better health than those taking alprostadil and therefore have a lower risk. [of heart issues]”He said.” To determine if this is the drug that reduces the risk, we would need to randomly assign patients to two groups, one who takes PDE5 and the other who does not. do not take it. The results we have now give us very good reasons to embark on such a study. “

The new report had no funding from the pharmaceutical industry. An earlier study by the same team found that men who have had a heart attack tolerate PDE5 drugs well, and they may extend life expectancy and have protective effects.

Holzmann said men with coronary artery disease should not hesitate to discuss erectile dysfunction issues with their doctors.

Two experts in the United States who were unrelated to the study said the results are intriguing, but more study is needed.

PDE5 drugs “are” vasoactive “which means that they have an effect on the blood vessels, making them less rigid and able to vasodilate,” explained Dr. Guy Mintz. He leads cardiovascular health at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, NY. “These agents may also have anti-inflammatory effects,” he added.

But Mintz stressed that “it is not a therapy for all patients with coronary artery disease, only those who suffer from impotence as well.”

And he agreed that the cause and effect has yet to be proven. “There is a need for follow-up studies to see if PDE5 inhibitors are directly responsible for the beneficial effects, or if the benefit is from having a partner (not being alone), an active sex life ( exercise) or a happier life approaching life (a sense of well-being), ”Mintz said.

Dr. Michael Goyfman heads the Clinical Cardiology at Long Island Jewish Forest Hills in New York. He agreed that, for now, the Swedish findings are only useful for generating theories – not for changing medical practice. He said that the best results for men taking PDE5 may have been based on their underlying health (perhaps only the sickest men received the injected drug alprostadil) or on their income (the most ill men were given the injected drug alprostadil). more affluent could afford Viagra or Cialis).

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

SOURCES: Guy L. Mintz, MD, director of cardiovascular health and lipidology, Sandra Atlas Bass Heart Hospital at Northwell Health, Manhasset, NY; Michael Goyfman MD, director of clinical cardiology, Long Island Jewish Forest Hills, New York; Karolinska Institute, press release, March 22, 2021

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