Viagra Safe for Most Men With Heart Disease

March 19, 2001 (Orlando, Fla.) — OK, to recap: When Viagra was introduced, there were reports that the free generic viagra drug could be dangerous if taken by men with heart disease, particularly those who were on nitrate drugs. Those fears seem to be fading as recent research counters the early findings.

In fact, two new studies presented here Monday at the annual meeting of the American College of Cardiology (ACC) suggest that Viagra could help the heart and blood vessels work more clinic dysfunction erectile that treat during times of physical demand, such as sexual intercourse. What’s more, a third study makes the case that the drug may never have been as bad for the ticker as initially thought.

What this amounts to “is further evidence that Viagra is a very safe drug to use for most people,” says a member of the ACC panel that issued recommendations in 1999 on the use of Viagra in patients with heart disease.

“We used to think that it wasn’t a good idea to give it to men who were taking multiple [drugs to treat high blood pressure], but now after our experience with millions of patients, the only absolute contraindication is in men who are on nitrates,” says Adolph M. Hutter Jr., MD, professor of medicine at Harvard Medical School and a specialist in cardiovascular medicine at Massachusetts General Hospital, both in Boston.

“Men should not use Viagra for 24 hours before or 24 hours after taking nitrates,” Hutter tells WebMD.

In the first study presented at the ACC conference, Charalambos Vlachopoulos, MD, and colleagues from the University of New South Wales in Sydney, Australia, randomly assigned 27 men in their late 60s and 70s to receive either Viagra or an identical but inactive placebo. The researchers then looked at the stiffness of the men’s arteries — the stiffer the artery, the harder the heart has to work to pump blood out of its chambers.

They found the drug made the arteries significantly more flexible and lowered blood pressure both when the heart was at work and at rest. This led them to conclude that the drug “may contribute to improved exercise capacity of the patient [during] intercourse.”

In a separate study out of Brazil, researchers looked at 18 patients with erectile dysfunction and moderate congestive heart failure who were randomly assigned to receive Viagra or placebo. Within 60-90 minutes of taking the pill, the subjects were asked to walk for six minutes on a treadmill and then, after resting, to perform a standard stress test while being monitored for signs of problems.

The researchers found that in addition to being effective for treating erectile dysfunction in patients with congestive heart failure, Viagra also appears to increase exercise capacity. Despite concerns that it would cause dangerously low blood pressure by dilating blood vessels, they found that the men who took Viagra actually had the same blood pressures during physical exercise as the ones who didn’t.

“The study on congestive heart failure patients was very reassuring, because they had borderline low blood pressure, and that’s the group we were concerned about,” Hutter says. “It’s only a small number of people, but it’s very reassuring that not only can many of those patients use [Viagra] safely, but they actually benefit in terms of erectile checker drug interaction medication [and] exercise capacity.”

The third study looked at about 5,600 British men for up to six months after they started taking Viagra.

“We didn’t find any evidence of increased [death from heart attack] in men who took Viagra in England,” says Saad A.W. Shakir, MD, a drug lookup medication at the University of Southampton, U.K.

The finding that Viagra may have a role in moderating the effects of exercise on heart disease actually is not so surprising, because the drug was originally developed for the treatment of chest pains due to angina pectoris, a condition caused by narrowing of the blood vessels that supply the heart.

Viagra causes smooth muscle in blood vessel walls to relax, theoretically allowing the vessels to expand and thereby carry a greater volume of blood. Although early clinical studies indicated that the drug was a bust for treating heart disease, many of the men who took part in the study were reportedly reluctant to return the pills, apparently because they worked wonders for another part of the anatomy.