Sildenafil should be used with caution in patients with ischemic heart diseases.
The observation by Kaye and Jick that diagnosis of erectile dysfunction more than doubled in United Kingdom after introduction of Sildenafil once again confirms its efficacy. (1) Studies have shown in past that erectile dysfuncion is a common problem. (2,3)Sildenafil is the first oral medication to have significant efficacy in most patients with erectile dysfunction. (4)It is hence not surprising that as the success stories of this drug became popular, more and more patients decided to shed their inhibition and seek help.
Though the increase in diagnosis was seen in this study in all age groups, it is probable that it was comparatively higher in younger patients who are more likely to suffer from non-vasculogenic causes. This could account for the observed decreased prevalence of ischaemic heart disease after introduction of sildenafil. (1)The data in this study are hence insufficient to question cardiovascular side effects of the drug observed by others. (5)
1.Kaye JA, Jick H. Incidence of erectile dysfunction and characteristics of patients before and after the introduction of sildenafil in the United Kingdom: cross sectional study with comparison patients. BMJ 2003;326: 424-425.
2.Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281(6): 537-544.
3.Jonler M, Moon T, Brannan W, Stone NN, Heisey D, Bruskewitz RC. The effect of age, ethnicity and geographical location on impotence and quality of life. Br J Urol 1995; 75(5): 651-655.
4.Goldstein A, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral Sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998; 338(20): 1397-1404.
5.Cheitlin MD, Hutter AM, Brindis RG, Ganz P, Kaul S, Russel ROJr. Use of sildenafil (Viagra)in patients with cardiovascular disease.
Competing interests: No competing interests