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Viagra Deemed OK for Men With Heart Disease

Erection pill cleared, but study urges men get doctor's nod before sex

TUESDAY, Feb. 12, 2002 (HealthDayNews) -- Men with heart trouble can have safe sex with Viagra by their bedside.

However, they should get their doctor's approval before trying to perform, suggests a new study that finds no link between the impotence drug and cardiovascular complications.

Since its introduction in 1998, Pfizer Inc.'s Viagra has been dogged by reports of potentially deadly heart problems in the men who take the blockbuster erection drug. While regulators warn users of the blue pill about cardiac complications, some experts have attributed the problems associated with it not to the drug but to sexual activity in men with weak hearts.

The latest study, which appears in tomorrow's issue of the Journal of the American Medical Association, supports that theory.

A research team led by Dr. Adelaide Arruda-Olson, a heart specialist at the Mayo Clinic, looked at the effects of Viagra on the cardiovascular system in 105 impotent men with known or likely coronary artery disease. The men, whose average age was 66, underwent two days of exercise testing on bicycles after taking either 50 milligrams or 100 milligrams of the erection drug or a dummy pill. During the tests, the researchers measured the men's exercise capacity, blood pressure, blood flow and other important cardiovascular properties.

Viagra did lead to a small drop in resting systolic blood pressure -- the top number -- compared with placebo. But that's not surprising, as it's known to dilate vessels, and the decrease was similar to what has been observed in healthy patients. Otherwise, the researchers could find no impact of the drug on any of the other measures of heart and vessel dynamics.

"It looks like if you compare Viagra to sugar pills in patients with coronary artery disease, the effects of the two were pretty much indistinguishable," says Dr. Patricia Pellikka, a Mayo Clinic cardiologist and a study co-author.

Pellikka calls the results "quite reassuring," and says patients shouldn't be afraid of the impotence drug. However, she adds, doctors may want to consider ordering exercise tests for some men with shaky heart function before giving them the green light for Viagra-aided lovemaking.

"It seems more likely that the [reduced blood flow] and cardiac events reported with [Viagra] are related more to the performance of sexual activity in a patient with coronary disease than the use of the drug," writes Dr. Thomas Marwick, of Princess Alexandra Hospital in Brisbane, Australia, in an accompanying editorial. For doctors considering prescribing Viagra to their patients with heart conditions, a "careful evaluation of functional capacity and thorough discussion with the patient about the risks of physical and sexual activity are essential," he writes.

Dr. Ira Sharlip, a San Francisco urologist and president of the Sexual Medicine Society of North America, says the latest results are consistent with an earlier study showing that Viagra was safe in men with more aggressive coronary disease.

"Most of us think that the problems with Viagra were really just related to physical activity," he says.

However, Sharlip notes that men taking nitroglycerin, a powerful vessel dilator, must not take Viagra because combining the two medications can be deadly.

What To Do

Coronary artery disease affects an estimated 7 million Americans, and is the leading killer of both men and women in this country, according to the National Institutes of Health.

For more on the condition, visit the National Heart, Lung, and Blood Institute.

For ways to reduce prevent coronary artery disease through dietary changes, try the American Academy of Family Physicians.

To find out more about Viagra, visit Pfizer.

SOURCES: Interviews with Patricia Pellikka, M.D., consultant, cardiovascular diseases, Mayo Clinic, Rochester, Minn.; Ira Sharlip, M.D., president, Sexual Medicine Society of North America, San Francisco; Feb. 13, 2002, Journal of the American Medical Association
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