Viagra has sat on pharmacy shelves for decades, helping men of all ages overcome erectile dysfunction and giving them a new lease of life in between the sheets. Despite its success, it was not always meant for this role – Viagra, or the active drug sildenafil, was originally created to treat high blood pressure and heart disease. It just so happened to have a pretty useful side effect of prolonged erections. However, men who have stable coronary artery disease that use Viagra as a helping hand for impotence may be getting more than they paid for, suggests a new study from the Karolinska Institute, and may actually live longer than people that take alternatives. Furthermore, these men appear to be at lower risk of new heart attack, indicating that the active component in Viagra could extend far beyond its current uses. Their results were published in the Journal of the American College of Cardiology. Viagra belongs to a class of drugs called PDE5 inhibitors. PDE5 inhibitors work on the smooth muscle cells that line blood vessels, causing the vessels to dilate and become larger. This allows more blood to flow through, combatting high blood pressure in patients with pulmonary hypertension. However, PDE5 inhibitors were previously thought to increase the risk of heart attack in men with coronary heart disease, the most common form of heart disease. This was proved wrong in 2017 by Martin Holzmann, showing that Viagra and similar drugs are safe and may even prolong life in men that had already had a heart attack. In their latest study, Holzmann and colleagues compared PDE5 inhibitors against another drug used for treating impotence, called alprostadil, in men with stable coronary heart disease. Commonly sold under the brand name Bondil, alprostadil is another vasodilator used regularly in older men with heart complications to treat erectile dysfunction. The sample included 16,548 men treated with PDE5 inhibitors and 1,994 men treated with alprostadil. After a study period of 5.8 years, 14 percent of the PDE5 group had died, compared to a significantly larger 26 percent in the alprostadil group. The men receiving PDE5 inhibitors lived longer, had a lower risk of a second heart attack, and lower risk of needing bypass surgery, suggesting that Viagra and similar drugs may not just be safe – they may be the best option for men with coronary heart disease suffering from impotence. Further evidence will be required to fully validate the findings, as although the sample for PDE5 inhibitors was large, the sample for alprostadil was comparatively small. However, the researchers believe this study warrants men to ask their pharmacist, GP or healthcare provider about this class of drug as an alternative. PDE5 inhibitors are prescription-only, so it requires men to have the courage to speak up and ask for help. “To find out if it is the drug that reduces the risks, we would need random patients to either get PDE5 inhibitors or not. The results we got now give a strong reason to do such a study,” says Holzmann, in a statement. Source
