2024-01-17 09:14:09
Dubai, United Arab Emirates (CNN) – The phosphodiesterase-5 inhibitor drug, also known as PDE5i, is a common treatment for men who suffer from erectile dysfunction, heart disease, and blood vessels.
But a new study published in the Journal of the American College of Cardiology, in which more than 60,000 men participated, found that taking this drug with nitrates, a common drug for chest pain, led to increased health risks, such as heart failure and early death. .
“Our goal is to emphasize the need for careful patient-centered study before prescribing PDE5i to men receiving nitrate therapy,” Dr. Daniel Peter Andersson, the study’s lead author and associate professor in the Department of Medicine at Karolinska Institutet in Stockholm, said in a press release. He added: “This finding justifies our efforts to continue research into the ambiguous effects of ED drugs and their impact on men with cardiovascular disease.”
A well-known, but growing, problem
The use of PDE5i by people with ED and cardiovascular disease has been controversial because the drug and nitrates induce a drop in blood pressure by acting on endothelial cells in different ways. Endothelial cells line blood vessels and regulate exchanges between blood and surrounding tissues. Previous studies focused on the benefits or harms of concurrent use.
But although current research and clinical guidelines discourage concurrent use of the drugs, Anderson noted, “Doctors are seeing an increase in requests for erectile dysfunction medications from men with cardiovascular disease.”
The study included 61,487 men from the Swedish National Registry of patients with stable coronary artery disease, a history of myocardial infarction, heart attack, or percutaneous coronary intervention between 2005 and 2013. Percutaneous coronary intervention, also known as revascularization, It is a non-surgical procedure that treats blockages in a coronary artery by opening blocked or narrowed parts of the artery and restoring blood flow to the heart.
Participants also received two prescriptions for nitrates, sublingual nitroglycerin, or oral nitrates, within six months. The authors looked at the effects of receiving at least two prescriptions for PDE5i drugs, such as sildenafil, vardenafil, or tadalafil.
Among participants, 55,777 men were treated with nitrates alone, while 5,710 men were treated with both nitrates and PDE5i. The average follow-up time was 5.7 years in the nitrate group, whose participants were regarding 70 years old. The follow-up time was 3.4 years in the second group, in which the participants were approximately 61 years old.
The group taking both drugs had a slightly higher risk of premature death from all causes. The risk of undergoing revascularization during the follow-up period was twice the risk of the group that took nitrates only.
Dr. Howard S. was not surprised. Herman, MD, professor at the John W. Breyfogle School of Cardiovascular Diseases at the University of Pennsylvania, reported the key findings.
Herman pointed out that experts have known “the potential risks such as low blood pressure as a result of taking this combination of the two treatments for decades… and the presence of erectile dysfunction in many patients who suffer from coronary artery disease, due to the presence of dysfunction in the lining of the blood vessels as a result of the two diseases.”
Herman, who also serves as chief of interventional cardiology at the Hospital of the University of Pennsylvania, added that he was “very surprised by the high frequency (9%) of patients who received both drugs.” He noted that this “should serve as an additional warning to doctors regarding prescriptions for these drugs.”
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