- Erectile dysfunction (ED) can be an early warning sign of heart disease or other circulatory issues.
- However, ED medications like Viagra, Cialis, and Levitra may improve heart health by affecting blood vessels throughout the body.
- New research suggests that this effect may protect men from heart attacks, stroke, and other major cardiovascular events.
- A study of 23,000 men with ED found that those who took medication to treat the condition had a 39% lower rate of death due to cardiovascular disease.
Having trouble getting or keeping an erection may seem like an issue for men only in the bedroom, but it is often an early
Viagra, Cialis, Levitra and similar
However, these drugs can also affect blood vessels in other parts of the body.
A new study suggests that this whole-body effect may protect men from heart attacks, stroke, and other major cardiovascular events.
The authors of the study write that this and other recent studies show that erectile dysfunction medications known as phosphodiesterase type 5 inhibitors (PDE-5is) “are not only safe but may have important cardioprotective properties.”
To examine the potential heart-related benefits of PDE-5i drugs, researchers obtained electronic health record data for over 23,000 men diagnosed with erectile dysfunction who were prescribed one of these drugs.
They compared them to a similar group of over 48,000 men with erectile dysfunction who were not prescribed a PDE-5i during the 2006-2020 study period.
Men who took a PDE-5i drug for erectile dysfunction, compared to those who didn’t, had a:
- 13% lower rate of a major adverse cardiovascular event such as heart attack, stroke or heart failure,
- 39% lower rate of death due to cardiovascular disease
- 25% lower rate of death due to any cause.
The heart-related benefits of PDE-5i medications were also seen in men who did not have diagnosed coronary artery disease, but who had risk factors for cardiovascular disease, including type 2 diabetes.
Researchers also found that men who were prescribed more PDE-5i pills during the study period had greater reductions in major adverse cardiovascular events and overall rate of death, compared to men who were prescribed the fewest number of pills.
The study was published on Jan. 13 in The Journal of Sexual Medicine. It was funded by a grant from Sanofi, which is working on obtaining regulatory approval for an over-the-counter version of Cialis.
Dr. Jim Liu, a cardiologist at The Ohio State University Wexner Medical Center in Columbus, Ohio, who was not involved in the new study, pointed out that PDE-5i medications work by opening (dilating) blood vessels.
This, he said, is how they improve symptoms of erectile dysfunction, by increasing blood flow in the penis.
Some of these drugs are also approved to treat
Because PDE-5i medications dilate the arteries, they can improve blood flow in the blood vessels to the lungs in people with this condition, said Liu.
“Therefore, it would make sense to think PDE-5 inhibitors might improve cardiovascular outcomes, because they may improve overall blood vessel health,” he added.
The authors of the new study also suggested other possible mechanisms for how PDE-5i drugs might have heart-related benefits, such as reducing the stiffness and inflammation of the arteries or reducing the clotting of the blood.
However, one limitation of the study, said Liu, is it was not designed to show whether PDE-5i medications are the cause of the observed heart-related benefits.
“The study only shows that there is an association between taking PDE-5 inhibitors and cardiovascular outcomes,” he said.
In addition, because researchers relied on health plan prescription claims, they don’t know how many of the PDE-5i pills men took.
“As we know, many erectile dysfunction medications are taken as needed,” said Liu, “so just filling a prescription does not necessarily translate into taking the medication.”
Men, in either group, could have also obtained PDE-5i pills from other sources, such as the internet or a friend.
Researchers also didn’t have data on how frequently men in either group had sex, “so it is not clear whether increased sexual activity may have contributed to the benefits seen,” the authors wrote.
However, the results are strong enough that they “suggest an urgent need for an adequately powered, prospective randomized placebo-controlled trial,” they said.
This kind of study could potentially be done in a group of men with risk factors for cardiovascular disease, who may not necessarily have erectile dysfunction.
Liu agreed: “I think the [new] study is trying to answer a very good question, but more studies are needed to get a more definitive answer.”