Fewer CVD deaths associated with erectile dysfunction pills
Men with stable coronary heart disease (CHD) treated for erectile dysfunction (ED) have a lower risk of death if their medication is a phosphodiesterase 5 (PDE5) inhibitor rather than alprostadil, according to observational data from Sweden. In addition, treatment with a PDE5 inhibitor was associated with a significantly lower risk of MI, revascularisation, hospitalisation for HF and cardiovascular mortality compared with alprostadil.To get more news about
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The results support the idea that there's something uniquely beneficial about PDE5 inhibitors, Daniel P. Andersson, MD, PhD (Karolinska University Hospital, Stockholm, Sweden) and colleagues report in a paper published this week in the Journal of the American College of Cardiology.
"Vasculogenic ED has been proposed to be an early manifestation of atherosclerosis and to precede the presentation of coronary artery disease," they explain. "Men with ED have been identified as a high-risk population for incident cardiovascular disease. Conversely, treatment of ED is associated with a lower risk of death and the development of cardiovascular disease".
The link between treatment and outcome was confirmed in an earlier analysis by the same group, which looked at men who had had a first MI, some of whom weren't receiving medication for ED.
This time, the researchers focused on men with stable CAD who were treated for ED with either a PDE5 inhibitor or alprostadil, in case there was something different between those who did and didn't get treatment, said senior author Martin J. Holzmann, MD, PhD (Karolinska University Hospital).
PDE5 inhibitors, whether sildenafil, tadalafil or vardenafil, are taken orally. Alprostadil, on the other hand, is a local vasodilator that wouldn't have systemic effects. He cautioned that this doesn't eliminate the potential for "confounding by indication" due to differences in who takes PDE5 inhibitors versus alprostadil.
Only a randomised controlled trial can provide definitive answers as to whether PDE5 inhibitors are cardioprotective, Holzmann emphasised. If successful, PDE5 inhibitors would be a novel addition to the drugs used to prevent cardiovascular events, he concluded. "It is a completely different mechanism. I think it's quite fascinating.
