Adverse cardiovascular events reported in patients taking sildenafil are not a result of the drug itself, according to the results of a US study of 14 men with severe coronary artery disease.
Dr Howard Herrmann and colleagues (cardiovascular division, University hospital of Pennsylvania) found that oral sildenafil produced only small decreases in systemic arterial and pulmonary arterial pressures and had no effect on heart rate, cardiac output, right atrial pressure or pulmonary-capillary wedge pressure. The authors say that their results suggest that sildenafil has no effect on coronary haemodynamics and that there must be an alternative explanation for reported adverse cardiovascular events following use of the drug. They suggest interactions with other drugs (eg, nitrates), an increase in myocardial oxygen demand as a result of sexual activity or shared risk factors for erectile dysfunction and coronary artery disease as possible explanations (New England Journal of Medicine 2000;342:1622).