Viagra, (sildenafil citrate) the wonder drug that became an instant sensation after being introduced in the nineties, fundamentally transformed how erectile dysfunction was treated. In general, this drug has always been considered to be safe for men with healthy hearts. The concern, however, lies in the potential dangers that might occur if used in patients with cardiovascular disease. Why exactly is that so and does this apply to all men with cardiovascular disease?

Viagra works by facilitating the release of nitric oxide in order to dilate blood vessels and thus increase blood flow. By vasodilating, blood flow resistance decreases and therefore helps decrease blood pressure. They estimate that viagra can decrease systolic blood pressure by about 8mmHg and diastolic blood pressure by about 5mmHg. With this in mind, it is those that are at risk of becoming hypotensive whom we are most concerned about, especially those who already have pre-existing hypotension or are taking medications that may potentially interact and amplify the actions of Viagra.  

Research shows that Viagra is safe for patients with stable coronary artery disease and even for those with severe coronary artery disease as long as they do not have any angina – chest pains caused by periods when the heart muscles are receiving insufficient blood flow.

Additionally, it seems that in the majority of those with cardiovascular disease as well as those being treated with anti-hypertensives, taking Viagra does not seem to pose a problem for them. Research has shown those taking antihypertensive medications with Viagra are unlikely to suffer from significant decreases in blood pressure or adverse side-effects and is considered a safe and effective combination for those using these drugs.  

This would be different however for patients on vasodilators that contain nitrates. The similarities in their mechanisms of actions mean that they may potentially cause significant hypotensive effects and other side effects such as fainting. Healthy volunteers who were given nitroglycerin with Viagra experienced a 25-50mmHg decrease in blood pressures. This certainly may prove dangerous especially for those with pre-existing hypotension hence, why Viagra is absolutely contraindicated in patients who are on nitrates. This includes those on medications such as nitroglycerin, long-acting nitrates such as isosorbide dinitrate or Isordil, nitroglycerin patches and the likes. 

Viagra is also contraindicated in patients with heart attacks, strokes, or arrhythmias problems with the heart’s pumping rhythm) in the previous six months and in those with unstable angina. The drug is also contraindicated for those with compromised blood to the rest of the body which includes patients with left ventricular outflow obstructions such as aortic stenosis, heart failure as well as impaired autonomic control of the blood pressure. This is because the problematic blood flow would only be worsened with a further drop in blood pressure. 

In general, we can conclude that besides those with conditions stated above, Viagra is feasible for use in a majority of patients with heart disease. We usually prefer advising patients to err on the side of caution and to always consult one’s doctor and be aware of the side-effects before starting any new medication. Visit https://www.doctoroncall.com.my/sildenafil-ubat-viagra for more information. 

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