Recently, a study published in the European Heart Journal suggested that men with erectile dysfunction (ED) may be at an increased risk of cardiovascular disease (CVD). Specifically, they claimed that men who took part in the study and were treated with Viagra may experience an elevated blood pressure (BP) spike. Is this claim true?
The Study
The claims made in the European Heart Journal aren’t new. Back in 2016, another study suggested that men with ED may be at an increased risk of type 2 diabetes. However, this was a small study with just 494 participants and has not been confirmed by other research. Now, with the latest study having a sample size of over 600 participants, the link between ED and CVD may be more convincing. Let’s take a closer look at what the study revealed.
What They Did
The researchers from the University of Montreal performed a retrospective cohort study using data collected from the General Hospital Database. The data included 14,244 adult men who were either taking part in a drug trial or were newly diagnosed with ED. About half of the participants (7,551) were taking either Viagra or sildenafil as part of the trial. The other 7,593 men were in the control group and were being treated with placebo.
The men were followed for an average of 19 months. During that time, 952 men in the control group and 602 men in the treatment group died. Additionally, the researchers looked at whether there was an increase in systolic blood pressure (SBP) as a result of the treatments and whether this was associated with an increased risk of CVD. The results for the two subgroups are shown in the below chart:
- Treatments vs. Controls (over 19 months):
- Mortality:
- Myocardial Infarction:
- Angina:
- Stroke:
- Heart Failure:
- Peripheral Vascular Disease:
- Arterial Thrombosis:
What They Found
After correcting for confounding factors, including age, body mass index, smoking status, alcohol use, and the use of other medications known to affect BP (e.g., sympathomimetics), they found that men treated with either Viagra or sildenafil had a higher risk of developing systolic hypertension than men in the control group. Specifically:
- For every 1-unit increase in log-transformed estimated daily dose of sildenafil or Viagra, the risk of developing systolic hypertension increased by 22% and 14%, respectively
- The association of increased risk of systolic hypertension with use of both medications remained significant after additional adjustment for estimated glomerular filtration rate (eGFR)
- The association of increased risk of systolic hypertension with use of both medications was significant among men with lower eGFRs (eGFR less than 60 mL/min/1.73 m2)
- Among men with an eGFR of 60 mL/min/1.73 m2or greater, the risk of developing systolic hypertension was not significantly different between those taking part in the trial and those in the control group.
Interpretation
One of the primary issues with these types of studies is that they rely on patients’ self-reported data to determine treatment efficacy. This can be a significant source of bias as patients may not always be honest about whether or not they were successfully treated with the study drug. Additionally, since the study focused on men with ED, the results may not apply to all women. Also, because of the retrospective design, there is a chance that the researchers did not have complete information about each patient. Thus, these results should be taken with a grain of salt. Nevertheless, even after adjusting for many confounding factors, the results of this study still stand out as notable. For those who are concerned about the future of their hearts and the health of their arteries, these results would seem to suggest that patients with ED may be at an increased risk of developing CVD. Clearly, more research is needed to confirm this finding, but it won’t hurt to be a little more careful about what you eat and how you live your life.