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New Viagra Study Eases Some Fears

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WebMD Health News

May 31, 2000 -- A new study shows that Viagra appears to be safe even for some men with severe heart disease, as long as they are not taking nitroglycerine or similar drugs for their conditions.

Reports of heart attacks in several men who had used Viagra had led researchers to worry that the drug might pose a special risk to those with heart problems such as angina (chest pain). But the study, published in TheNew England Journal of Medicine, shows that the usual dose of Viagra causes no damaging changes to the heart's circulation in men with coronary artery disease (CAD).

Lead author Howard C. Herrmann, MD, tells WebMD that his findings "should provide reassurance about the safety of Viagra for patients who take it, for urologists who prescribe it to treat erectile dysfunction, and for cardiologists, who probably don't ask about erectile dysfunction as often as they should." Herrmann is professor of medicine and director of interventional cardiology at the University of Pennsylvania Medical Center in Philadelphia.

Herrmann and colleagues measured Viagra's effect on blood flow to the heart and lungs in 14 men with severe coronary artery disease. CAD is a major cause of angina and heart attacks. For the study, men had to stop taking nitrate-containing drugs such as nitroglycerin, which is often used to treat angina.

All of the men in the study had CAD so severe that at least one of the major arteries supplying the heart with blood had closed up by 70 percent or more. The study was supported by Pfizer, the maker of Viagra.

Herrmann reports that careful examination of the blood flow within the arteries showed that Viagra had essentially no effect on blood flow to the heart or lungs, or on the heart's ability to pump blood.

"Our data support the consensus position of the American College of Cardiology and the American Heart Association that Viagra is safe for patients with stable coronary artery disease who are not taking medications containing nitrates," Herrmann writes.

Rohit R. Arora, MD, who reported one of the first cases of heart attack in a patient who had taken Viagra, tells WebMD that this "well-done, meticulous, and focused" study provides useful information about Viagra's effects on the heart's circulatory system, but he would like to see more direct information about heart attacks in men taking the drug. Ahora, who is director of critical cardiac care services at Columbia-Presbyterian Medical Center in New York, was not involved in the study.

Herrmann says the safety of Viagra has not been studied in patients who have unstable angina, who have had a recent heart attack, or who have severe high or low blood pressure.

People who have not previously had even moderate exercise (including sexual activity) or who are taking more than one drug for high blood pressure should be cautious when beginning Viagra, Herrmann says. He recommends that those who have not been exercising regularly have a stress test, since sexual activity itself carries a small increased risk of heart attack. He also recommends that those with high blood pressure take their first dose of Viagra in a doctor's office, where the effect on their blood pressure can be checked immediately.

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