Treat Erectile Dysfunction With Viagra When You Have Heart Disease

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Viagra (sildenafil) has been life changing for many people with erectile dysfunction (ED), leading to robust and satisfying sex lives. However, this drug and others in a class of drugs called phosphodiesterase type 5 inhibitors (PDE5 inhibitors) may not be safe for people with certain types of heart disease.

There are two reasons for this :

  • How these drugs affect blood pressure
  • Their potential to interact with nitrates, a class of drugs sometimes prescribed to treat angina (chest pain)

Other PDE5 inhibitors for ED

Besides Viagra, there are four PDE5 inhibitors approved by the FDA to treat erectile dysfunction:

  • Cialis (tadalafil)
  • Levitra (vardenafil)
  • Staxyn (vardenafil)
  • Stendra (avanafil)
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Heart disease and ED

Erectile dysfunction and heart disease are inextricably linked. People with erectile dysfunction have an increased risk of also having heart disease and vice versa. This is because both can be associated with vascular disease, conditions that affect the blood vessels and circulation.

In fact, vascular disease accounts for 70% of erectile dysfunction. These conditions include atherosclerosis (hardening of the arteries), hypertension (high blood pressure) and high cholesterol.??

Heart disease and Viagra

Viagra and other PDE5 inhibitors prescribed for the treatment of erectile dysfunction drugs are vasodilators, which means that they work by dilating (widening) blood vessels to allow free flow of blood to the penis. which is essential for a robust erection.

In doing so, Viagra lowers systolic blood pressure (the “top” number in blood pressure readings) by an average of 8 mmHg.For most people with heart disease, including those who take medication to treat high blood pressure, this is not a problem.

However, according to the Food and Drug Administration (FDA), cases of myocardial infarction (heart attack), stroke, irregular heartbeat (arrhythmias) and even death have been reported in people taking Viagra. .

Most of these men, but not all, had heart problems before taking this medicine. The FDA notes that it is not possible to determine whether these events were directly related to Viagra.??

There are also certain heart conditions in which a modest drop in systolic blood pressure caused by Viagra can be dangerous:

  • Severe heart failure accompanied by borderline hypotension (hypotension) defined as resting hypotension (blood pressure less than 90/50) or resting hypertension (blood pressure greater than 170/100)
  • Severe aortic stenosis with low blood pressure which may worsen in response to medication
  • Hypertrophic cardiomyopathy (a genetic disease in which the walls of the heart become thick). People with this condition may develop symptoms if their systolic blood pressure drops.
  • Ischemia (periods when the heart muscle does not receive sufficient blood flow, most commonly manifested by chest pain)

Also, people with pulmonary veno-occlusive disease (PPVD) (a rare form of pulmonary hypertension) should not take Viagra.??

Drugs interactions

At one time, drugs called nitrates, such as nitroglycerin, were the mainstay of treatment for coronary artery disease. For the most part, this is no longer the case, thanks to procedures such as angioplasty and stenting.

However, for people who take nitrates, Viagra is dangerous, according to the American College of Cardiology and the American Heart Association. This is because, like Viagra, nitrates work by widening blood vessels.

Taking both drugs creates a significant risk of severe low blood pressure, which can lead to shock by depriving the brain and other organs of oxygen.??

Nitrates of concern

These nitrates should not be taken with Viagra:

  • Nitroglycerine
  • Amyl nitrate
  • Alkyl nitriles (“poppers”)
  • Isosorbide mononitrate
  • Isosorbide dinitrate
  • Sodium nitroprusside

There are also other heart disease medicines that may interact with Viagra and erectile dysfunction medicines, including certain blood pressure medicines and Tracleer (bosentan), which is a medicine used to treat high blood pressure. pulmonary (PAH).

Non-drug treatment options for ED

If you have erectile dysfunction but have heart disease, or if you are taking a drug that may interact with Viagra and other erectile dysfunction drugs, there are other options, namely changes in the way that help improve the ability to achieve and maintain an erection:??

  • Exercise. Moderate to vigorous aerobic exercise and weight training may be beneficial.
  • Weightloss can reduce the stress that extra pounds place on the cardiovascular system.
  • Healthy food for the heart emphasizes fresh produce, whole grains, lean protein, and healthy fats, with limited consumption of red meat, whole dairy products, added sugar and salt.
  • Stop habits that can interfere with blood flow– especially smoking, which is a known cause of erectile dysfunction. If you drink a lot, reduce your alcohol intake. The use of illegal drugs can be an underlying factor in erectile dysfunction (as well as an overall health risk).
  • Sex therapy can solve psychological problems are a common obstacle to getting an erection. Working with a professional therapist can help ease anxiety or emotional issues that contribute to erectile dysfunction.

If you are new to exercise, or have not been participating in regular physical activity for a while, talk to your healthcare professional before starting a fitness program. They can make sure you’re healthy enough to exercise and determine how much and what type of exercise you can safely do to begin with.

A word from Verywell

Serious cardiovascular complications caused by Viagra and other drugs to treat erectile dysfunction are rare. But if you are struggling with erectile dysfunction, you and your healthcare professional should carefully consider the risk of such problems before taking any PDE5 inhibitor.

But even if it is determined that Viagra is safe for you, also consider taking non-pharmaceutical measures to treat erectile dysfunction: you may find that you can fix the problem without medication and you will definitely improve your health and your general well-being.

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