January 10, 2026Systematic Reviews1 citationsOpen Access

Associations between phosphodiesterase type 5 inhibitors and vascular function: a systematic review and meta-analysis on randomized-controlled trials

YZYucong ZhangTongji Hospital HPHao PengAgricultural Research Service SXSheng XinTongji Hospital

Key Result

PDE5 inhibitors were associated with improved vascular function parameters compared to placebo in randomized controlled trials.

Key Points

This research aims to analyze the relationship between phosphodiesterase type 5 inhibitors and vascular function based on existing randomized-controlled trials.
Conducted a systematic review of randomized-controlled trials
Evaluated vascular parameters associated with phosphodiesterase type 5 inhibitors
Utilized meta-analysis techniques to combine data from multiple studies
Found positive associations between phosphodiesterase type 5 inhibitors and improved vascular function
Highlighted variations in efficacy among different studies
Indicated potential therapeutic benefits for vascular health

Structured PICO

Do phosphodiesterase type-5 inhibitors improve vascular parameters compared to placebo in diverse patient populations?

Population

63 RCTs pooling 3,242 participants. Populations included healthy individuals (14 trials), patients with erectile dysfunction (18 trials), and participants with other conditions (31 trials) including chronic heart failure (n=10), hypertension (n=6), coronary artery disease (n=4), diabetes mellitus (n=3), smoking (n=3), cystic fibrosis (n=1), mixed connective tissue disease (n=1), Tetralogy of Fallot cardiac surgery (n=1), and status post-Fontan procedure (n=1).

Intervention

Phosphodiesterase type-5 inhibitors (PDE5is) as a class (including sildenafil, vardenafil, tadalafil, lodenafil, udenafil, avanafil)

Comparator

Placebo

Outcome

Vascular parameters including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), carotid intima-media thickness (cIMT), peak systolic velocity (PSV), pulse wave velocity (PWV), augmentation index (AI), brachial artery diameter (BAD), reactive hyperemia index (RHI), flow-mediated dilation (FMD), endothelial progenitor cells (EPCs), and endothelial microparticles (EMP)surrogate

PDE5 inhibitors significantly improve multiple surrogate markers of vascular and endothelial function, including blood pressure, arterial stiffness, and flow-mediated dilation, suggesting potential therapeutic value for subclinical cardiovascular disease.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The present study protocol was reviewed and approved by PROSPERO. The title is "Associations between PDE5is and vascular parameters: A systematic review and meta-analysis" (https://www.crd.york.ac.uk/PROSPERO/) (Reg. No. CRD42023387924).

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