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How Good is Viagra for the Heart?

November 27, 2014

Originally studied as a heart drug, Viagra could come full circle and be used to treat certain heart conditions.


In the 1980s, Pfizer scientists in England were trying to find a new treatment for the painful heart condition called angina, which is caused by insufficient blood flow to the heart.


In their studies, researchers focused on a substance called PDE-5, which is present in high levels in the smooth muscle that lines blood vessels. The idea was that inhibition of PDE-5 might improve blood flow and help alleviate the pain caused by angina. Studies on animals in the late 1980s of a PDE-5 inhibitor developed by Pfizer showed enough promise to lead to human studies.


The first studies were disappointing, showing minimal effects on parameters like blood pressure and cardiac output. The compound would have been forgotten completely except it had the unexpected side effect of making men have stronger erections. The result was the blockbuster drug Viagra.


It appears the drug may have come full circle regarding cardiac treatment. New studies show that although Viagra doesn’t help much with angina, it may be very useful in treating other heart conditions.


But Doesn’t Viagra Packaging Include Warnings for Heart Patients?


For several years now, Viagra has included warnings directed at men who have heart problems. Specifically, men who take drugs called nitrates for cardiac problems should not take Viagra because it can cause a sudden, serious drop in blood pressure. Additionally, the nitrates found in recreational drugs like amyl nitrate (a “club†drug known as “poppersâ€) can react dangerously with Viagra and cause a sudden, dangerous plunge in blood pressure.


However, new studies are finding that for certain heart conditions in people who do not take nitrates, Viagra may actually have beneficial effects on the heart.


Heart Conditions That Could Benefit from Viagra


Cardiac hypertrophy (enlargement of the heart) and heart failure are two heart conditions that may improve with ongoing use of a lower dose of Viagra than is used for erectile dysfunction. The PDE-5 inhibiting action of Viagra has shown clinically meaningful improvements in heart performance and in a process called cardiac remodeling. Cardiac remodeling refers to changes in the size, shape, and structure of the heart after injury from a heart attack, congenital heart disease, heart valve disease, or heart failure. Eventually, cardiac remodeling results in diminished heart function. Recent studies with Viagra have shown good cardiovascular safety even in older patients and with prolonged use.


Cardiac researchers in Rome performed a meta-analysis of randomized, placebo-controlled trials evaluating effectiveness and safety of the Viagra on cardiac structure and function. Analysis of studies that reported cardiovascular outcomes related to cardiac structure and performance as well as safety found that the drug appears to help prevent cardiac remodeling and improve cardiac function while maintaining a good safety profile. It could prove very useful in men with cardiac hypertrophy and early heart failure.


Further Studies That Need to Be Done


One of the biggest deficiencies in the studies that were analyzed by the Italian researchers has to do with the reasons Viagra is prescribed in the first place. In other words, none of the studies used in the meta-analysis included women, who suffer from heart failure, cardiac hypertrophy, and cardiac remodeling too. Researchers will need to study the effects of the drug on heart function in women, and will also need to clarify differences in how the drug works between the two sexes. It’s possible that Viagra might interact with estrogen, which is considered protective to the heart, and researchers need to understand how the drug affects women specifically.


Additionally, larger, long term clinical trials would be needed, focusing on cardiovascular response, before the drug could be prescribed as a treatment for these heart conditions. At this time, no drug company has come forward as willing to invest in the type of long term, expensive trials that would be required. Even Pfizer may not be interested, since Viagra is already off-patent in many countries, and will be off-patent in the US in 2020. Finding funding for necessary studies could prove difficult.


A New Reason to Prescribe Viagra Could Boost Sales Two Ways


On the other hand, should beneficial effects of Viagra on the heart be confirmed by further research, it could result in increased sales. Moreover, if other PDE-5 inhibitors, like the ones in erectile dysfunction drugs Levitra and Cialis are eventually studied, they too could possibly be prescribed for conditions other than erectile dysfunction.


Researchers have also pointed out the possible “destigmatizing†effect that Viagra for heart problems could have. It could, for example, be more psychologically acceptable for some men to justify usage of Viagra due to a heart condition than admit to taking it for its benefits in the bedroom. Discussion of erectile dysfunction is far less off-limits than it used to be, but it is still a difficult topic for many men and their partners.


Studies of Viagra’s effects on women’s heart still need to be done.


Viagra Is Used for Many Other Medical Conditions


Viagra is already prescribed under the name Revatio for a serious lung condition called pulmonary arterial hypertension. And it has been or is being studied in a huge range of medical conditions from altitude sickness to certain types of muscular dystrophy to specific pregnancy complications. It is interesting to think that, had the side effect of improving erectile dysfunction gone unnoticed or been ignored a generation ago, the many potential uses of PDE-5 inhibitors may never have been known.


Conclusion


Viagra is one of the best selling drugs of all time, and has helped millions of men worldwide cope with erectile dysfunction. In the years since it has been on the market, it has been studied as a treatment for many non-sexual conditions, and has shown surprising versatility. Now the drug that started out as a potential treatment for specific heart conditions may turn out to be a viable treatment for other heart conditions. There is certainly interest among cardiologists in learning whether Viagra could help with common and debilitating conditions like heart failure.


AccessRx.com has, in partnership with US-licensed pharmacists, dispensed Viagra and other medications for erectile dysfunction to hundreds of thousands of satisfied customers for over 15 years. AccessRx.com is dedicated to helping men cope with erectile dysfunction and obtain the medications they need conveniently, cost-effectively, and with utmost concern for customer privacy and online security.