Reviews phosphodiesterase-5 inhibitor mechanisms and efficacy in patients with cardiovascular disease and erectile dysfunction, highlighting their therapeutic role in outpatient clinical practice.
About 150 million men worldwide and about 50% of men aged 40-88 y.o. in outpatient practice suffer from erectile dysfunction (ED). There is a linear relation between the age and ED rate. The main reason of ED in the majority of men (about 80% of patients) is cardiovascular diseases (atherosclerosis, hypertension, diabetes mellitus), as well as certain risk factors (smoking, alcohol abuse, physical inactivity etc.). The problem of ED in cardiac outpatients and modern pharmacotherapy is discussed. The phosphodiesterase-5 (PDE5) inhibitors increase the relaxing effect of nitric oxide and increase cyclic GMP levels during sexual arousal. It results in increase of cavernosum blood flow, contributing to the physiological erection. Three PDE5 inhibitors (sildenafil, tadalafil, vardenafil) are used in clinical practice nowadays.
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Мамедов et al. (2010) studied this question.
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