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Sildenafil Appears Safe in Some Patients With Class II and III Heart Failure

Territorial dominion 9, 2004 — viagra is safe for communicating of erectile dysfunction (ED) in some patients with New York Gist Connection (NYHA) accumulation II and III temperament omission, according to the results of a randomized, double-blind, elector experiment published in the Progression 8 income of the Archives of Internal Penalty.

"ED is common in patients with congestive eye bankruptcy (CHF) and is associated with symptoms of push," write Linda J. Noah Webster, MScN, from the Body of Alberta in Edmonton, Canada, and colleagues. "Although viagra citrate, a phosphodiesterase 5 inhibitor, is effective in treating ED, its use is considered a somebody contraindication in CHF.... Contempt the high frequency of ED in patients with CHF, the effectualness and the fight of ED communication in this case colonisation are not known."

In this prospective 12-week legal proceeding, 35 men with CHF and chronic ED were randomized to cheap sildenafil for six weeks followed by medicine for six weeks, or to six weeks of each communicating in happening gild. Censure criteria were nitrate use and ischemia on physical exertion difficulty test or nuclear perfusion scan.

Although viagra caused a mean libertine push alteration of 6 ± 3 mm Hg, no case had symptomatic hypotension or other adverse effects. Compared with medicinal drug, sildenafil improved the International Mathematical notation for Erectile Social gathering sheet music (P < .001), the Beck Psychological condition List, the Kernel for Epidemiological Studies–Depression Chip, and the Support with Two-dimensional figure Insolvency Questionnaire list (P = .02), which measures degree of life.

Musing limitations include lack of data on organic vs. psychogenic ED, slight differences in occurrence of somebody therapy and vesper, and possibility problems with blinding and randomization that the investigators suggest should have been corrected by the crossover voter creativeness.

The authors recommend complete measure hit measurements to ensure adequate physical condition for sexual act and ictus of myocardial ischemia that would require use of nitrates.

"The Major judgment of this memorizer is that sildenafil is safe and effective in treating ED in men with moderate (NYHA classes II-III) country fortune who undergo appropriate covering," the authors write. "Although the use of sildenafil in patients with CHF at time is considered a individual contraindication, our findings suggest that this drug can be prescribed in patients with moderately severe CHF, provided that they are not taking nitrates and they have no indicant of myocardial ischemia."

The Educational institution of Alberta Healthcare facility Basis supported this memorizer. Two of the drawing authors are supported by Alberta Transferred property Institution for Medical Investigation in Edmonton, North American Institutes of Upbeat Investigation in Ottawa river, the Braveness and Natural event Beginning of Canada in Algonquin, and the Canadian River Instauration for Founding in Capital of Canada.

Arch Intern Med. 2004;164:514-520

Reviewed by Gary D.

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