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Good News for Heart Patients With Impotence

Many More May Be Candidates for Erectile Dysfunction Drugs
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June 28, 2005 -- Important new research shows that many heart patients with erectile dysfunction may be able to safely stop taking the heart medication that makes them ineligible for erectile dysfunction drugs.

A sexual medicine specialist calls the findings "groundbreaking," and a noted cardiologist says there is a growing appreciation for the importance of offering heart patients treatment options that make sex possible.

"The answer to the question, 'Can patients with heart disease safely have sex?' is almost always 'Yes,' unless they have such bad heart failure or severe artery disease that even a moderate amount of exertion will cause terrible chest pain," says Richard Stein, MD, who is director of preventive cardiology at New York City's Beth Israel Hospital. "And if that is the case, sex is probably the last thing on their minds anyway."

Nitrates and Erectile Dysfunction Drugs Don't Mix

Impotence is common among men with heart problems. So common, in fact, that erectile dysfunction is increasingly being recognized as an early warning sign for heart disease.

Heart patients are often treated with drugs called oral nitrates, such as Nitro-Dur and Isordil, in addition to other medications.

Men on nitrates cannot take erectile dysfunction drugs like Viagra, Levitra, or Cialis because the combination can cause dangerous drops in blood pressure.

In the newly reported study, London cardiologist Graham Jackson, MD, and colleagues wanted to find out if men with erectile dysfunction and stable heart disease could safely stop taking nitrates to allow for safe use of an erectile dysfunction drug.

They defined stable heart disease as a man with no significant exercise limitations (for example, they could walk 1 mile on flat ground without stopping). In addition, the men needed nitroglycerin under the tongue less than once a month for chest pain.

No Chest Pain When Nitrates Stopped

The researchers studied 55 men who were considered good candidates for stopping nitrates following exercise stress tests.

All the men taken off nitrates were taking low-dose aspirin along with other heart drugs. Only three of the men had an increase in heart symptoms a week after discontinuing their oral nitrates. More than 90% of these men began taking an erectile dysfunction drug, and 85% of those followed for three months or more reported restored sexual function.

The men taking the erectile dysfunction drugs reported no increase in chest pain or heart attacks after three months. The findings are reported in the July issue of The Journal of Sexual Medicine.

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