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Dubai, United Arab Emirates (CNN) — The phosphodiesterase-5 inhibitor, also known as PDE5i, is a common treatment for men suffering from erectile dysfunction, heart disease and blood vessel disease.
But a new study published in the Journal of the American College of Cardiology that involved more than 60,000 men found that taking this drug along with nitrates, a common chest pain medication, led to increased health risks such as heart failure and heart failure Death. .
“Our goal is to highlight the need for a careful patient-centered study before prescribing PDE5i to men receiving nitrate therapy,” said Dr. Daniel Peter Andersson, lead author of the study and associate professor in the Department of Medicine at Karolinska Institutet in Stockholm, released a press release. He added, “This finding justifies our efforts to continue research into the unclear effects of ED medications and their impact on men with cardiovascular disease.”
A well-known but growing problem
The use of PDE5i in people with ED and cardiovascular disease is controversial because the drug and nitrates cause a decrease in blood pressure by acting on endothelial cells in different ways. Endothelial cells line blood vessels and regulate the exchange between blood and surrounding tissue. Previous studies have focused on the benefits or harms of concurrent use.
But although current research and clinical guidelines advise against taking these medications together, Anderson noted, “Physicians are seeing increasing demand for erectile dysfunction medications from men with cardiovascular disease.”
The study involved 61,487 men from the Swedish national registry of patients with a history of stable coronary artery disease, myocardial infarction, heart attack or percutaneous coronary intervention between 2005 and 2013. Percutaneous coronary intervention, also called revascularization, 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 examined the effects of receiving at least two prescriptions for PDE5i medications such as sildenafil, vardenafil, or tadalafil.
Among participants, 55,777 men were treated with nitrates only, 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 about 70 years old. In the second group, where the participants were around 61 years old, the follow-up period was 3.4 years.
The group that took both drugs had a slightly higher risk of premature death from all causes. The risk of revascularization during the follow-up period was twice as high as the risk of the group taking nitrates alone.
Dr. Howard S. wasn’t surprised. Herman, MD, professor at the John W. Breyfogle School of Cardiocular Diseases at the University of Pennsylvania, reported key findings.
Herman pointed out that experts have “known for decades the potential risks such as low blood pressure as a result of taking this combination of the two treatments… and the presence of erectile dysfunction in many patients suffering from coronary artery disease due to the presence.” a 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 receiving both drugs.” He pointed out that this “should serve as an additional warning to physicians before prescribing these medications.”
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