Why the study?
Is sildenafil safe to use in patients with cardiovascular disease?
Is sildenafil safe to use in patients with cardiovascular disease?
Sildenafil use in cardiovascular patients requires strict avoidance of concurrent nitrates and careful individual assessment in those with ischemia, heart failure, or complex antihypertensive regimens.
Requires strict nitrate avoidance with sildenafil plus individualized assessment in high-risk CVD; confirms established guideline cautions.
A. Use of Viagra clearly contraindicated 1. Concurrent use of nitrates (see Appendix A) B. Cardiovascular effects of Viagra may be potentially hazardous (use dependent on individual clinical assessment) 1. Patients with active coronary ischemia who are not taking nitrates (eg, positive exercise test for ischemia) 2. Patients with congestive heart failure and borderline low blood pressure and borderline low volume status 3. Patients on a complicated, multidrug, antihypertensive program 4. Patients taking drugs that can prolong the half-life of Viagra (see Appendix B)
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Cheitlin et al. (1999) studied this question.
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