The demand for Viagra has continued to grow worldwide since Pfizer brought it to market as the first oral treatment for erectile dysfunction in the 1990s. In Italy, there are about 66,000 men who take the blue pill every day, with Campania in the lead, followed by Liguria and Tuscany, according to the Osmed report 2021. Now, a new study, coordinated by researchers at theUniversity of Southern California, found that men who take Viagra, or similar erectile dysfunction drugs (PDE-5i protein inhibitors), have a reduced risk of developing cardiovascular disease and dying prematurely from all causes. The research, published in the Journal of Sexual Medicinewas funded by Sanofi, a company that manufactures a PDE-5i protein inhibitor. Therefore the results, although promising, must be interpreted with caution.
Brief history of Viagra
The drug, also known by the chemical name “sildenafil”, was developed in the 90s with the aim of treating angina pectoris, a chest pain caused by poor blood flow in the coronary arteries (it had to dilate the blood vessels of the heart by blocking the PDE-5i protein). The tests do not give the desired results, but on the other hand show an unexpected sexual side effect: the drug increases blood flow to the penis following sexual stimulation, promoting an erection. Sildenafil worked, therefore, but in a different point of the body than expected: thus the first pill against impotence was born, approved by the Food and Drug Administration in 1998 (the year in which it also arrives in Italy).
In 2005, then the FDA and the EMA (European Medicines Agency) also authorized the drug for another condition, pulmonary arterial hypertension (occurs when the blood pressure in the pulmonary arteries and in the right side of the heart reaches levels too high). The drug is the same, but in this case it is sold as “Revatio”.
I study
The researchers therefore knew the cardiovascular benefits of these types of drugs for some time, however they wanted to further investigate these effects on heart health in a large male population and over the long term. They examined the 14-year medical records of more than 23,000 American men (with an average age of 52) who were prescribed a phosphodiesterase type 5 inhibitor (PDE-5i) between 2006 and 2020 for erectile dysfunction, and compared them to 48,000 other men, the same age, who had never received a prescription for this type of drug.
Viagra reduces the risk of dying from cardiovascular disease by 40%.
From the analysis of the data it emerged that the drugs for erectile dysfunction had reduced the probability of dying from cardiovascular disease by 39%, the probability of dying from all causes by 25%, the probability of having a heart problem by 13%, such as a heart attack or stroke. In particular, those who had taken drugs for erectile dysfunction were 17% less likely to suffer from heart failure and 22% less likely to develop coronary artery problems.
Furthermore, men who took a higher cumulative dose of PDE-5i were better protected against these heart diseases than those who took a lower dose. This effect was confirmed even after adjusting the results according to the age of the participants, the concomitant intake of other drugs, the presence of chronic pathologies and bad habits such as cigarette smoking.
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Why does Viagra have a protective effect on the heart?
Research shows that PDE-5i inhibitors have a positive effect on heart and arterial health, but as this is a retrospective observational cohort study, it does not explain the causal link. In this regard, researchers have hypothesized that these drugs, by increasing blood flow in the arteries of the heart, and therefore the flow of oxygen throughout the body, reduce the risk of atherosclerosis and the consequent cardiovascular dangers.
“However – the researchers explained – those who take Viagra could simply be healthier and more active than their peers who do not feel the need to improve their sex life, and therefore have lower health risks. But, even if unlike the pills, it is not certain that the effects depend directly on the action of the drugs on the cardiovascular system: in fact, it could be sexual activity that makes an improvement in health possible”.
A clinical study is needed to investigate causality
Many experts agree in deeming the data emerging from the new study very interesting, and worthy of further study. “The study is interesting,” said cardiologist Deepak Bhatt, director of the Mount Sinai Heart di New York -, but a randomized clinical trial in which many patients with cardiovascular disease are randomly given Viagra or a placebo is needed to know if there is any real cardiovascular benefit to the drug. While it is possible that Viagra may have some cardiovascular benefits, this requires further investigation.”
Meanwhile, those who use Viagra can continue to do so, remembering that it is a safe and effective drug in improving sexual well-being, mood and quality of life, but on condition that it is correctly prescribed by the doctor.