Question:
A preeminent cardiologist reports, for
the first time in a large prospective study, that certain of his patients
with erectile dysfunction (ED) and heart problems can now safely use
erection drugs that help up to 80% of men restore function and quality of
life. Dr. Graham Jackson, who established a unique clinic in England
dedicated to providing sexual advice to men with cardiac disease and ED,
conducted the largest scientific study of its kind, on 425 men with ED and
cardiac disease. In the study, appearing in the July issue of The Journal of
Sexual Medicine, Dr. Jackson wished to see if stable coronary patients with
ED could have their oral nitrates discontinued to allow for safe use of a
PDE-5 inhibitor, such as Viagra, Levitra or Cialis. More than half of the
men on oral nitrates who were clinically stable with good ability to
exercise had their nitrates discontinued in the presence of continuing
beta-blockade or calcium antagonist therapy and close follow-up. Over 90% of
the men no longer taking nitrates were treated with a PDE-5 inhibitor which
was effective in restoring sexual function in 85%. Importantly, there have
been no adverse cardiac events in the group. "This is a huge, groundbreaking
advance in our field that shows how multidisciplinary sexual medicine really
is," states Irwin Goldstein MD, Editor-in-Chief of The Journal of Sexual
Medicine. "Coordinating care between the sexual medicine physician and the
cardiologist has provided new evidence-based, prospective data to support
better clinical care for those men with ED and cardiac disease, who
historically have been denied such care. We now know that oral nitrates can
be discontinued in the presence of continuing beta blockade and/or calcium
antagonist therapy in stable coronary disease patients with ED to allow for
the safe use of PDE-5 inhibitors." The Center for Disease Control and
Prevention estimates that 1 in 12 (8%) or 22 million adults in the US have
heart disease. In the US, the prevalence rate for those who have angina
pectoris is 17.5 per 1000 people. Nitrate therapy is an absolute
contraindication to the use of PDE-5 inhibitors, however, since oral
nitrates confer little benefit when added to optimum doses of beta blockers
and/or calcium antagonists, it followed that stable patients may be able to
have their nitrate therapy discontinued or exchanged for a drug that does
not react with a PDE-5 inhibitor, such as a calcium antagonist or beta
blocker. "If you are on nitrates, the best advice is to see your doctor,"
Answer:
Wow! 85% Now if they only had a study of those that quit taking the pills;
we could call it a cure.
