Magazine article Drug Topics

Should Heart Patients Use Viagra? Guidelines Provide a Road Map

Magazine article Drug Topics

Should Heart Patients Use Viagra? Guidelines Provide a Road Map

Article excerpt

The vast majority of patients with heart disease can safely use Viagra [sildenafil, Pfizer]," declared Adolph M. Hutter, M.D., cardiologist at Massachusetts General Hospital. His statement was meant as the bottom line message taken from the recently released recommendations for the safe and appropriate use of sildenafil in patients with cardiovascular disease. The joint consensus document of the American College of Cardiology and the American Heart Association was developed to caution, yet not alarm, health-care professionals who wish to utilize the rather controversial phosphodiesterase inhibitor in the aforementioned patient population.

In addition to reemphasizing the clearly contraindicated use of nitrates and sildenafil within 24 hours of each other, the report listed various conditions that may predispose users of sildenafil to potentially hazardous cardiovascular effects. Included in that category are patients with active coronary ischemia who are not receiving nitrates. "We recommend that prior to being given sildenafil, these individuals have an evaluation, such as an exercise test, to make certain that they don't have marked ischemia that might be precipitated with the resumption of intercourse," noted Hutter, who is also a professor at Harvard Medical School and co-chair of the expert consensus statement on sildenafil.

Other patients who should undergo individual clinical assessment before being given an Rx for Viagra are those with concurrent congestive heart failure (CHF), borderline low blood pressure (BP), and borderline low-volume status. …

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