June 21, 2005 -- 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 inEngland 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 betablockers 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," says Dr. Goldstein.
This study is published in The Journal of Sexual Medicine.
About The Journal of Sexual Medicine
The Journal of Sexual Medicine is the official journal of the International Society for Sexual Medicine and its five regional affiliate societies. The aim of the journal is to publish multidisciplinary basic science and clinical research to define and understand the scientific basis of male and female sexual function and dysfunction. For more information on The Journal of Sexual Medicine, please visit http://jsm.issir.org.
About The International Society for Sexual Medicine
The International Society for Sexual Medicine (ISSM) was founded in 1982 for the purpose of promoting research and exchange of knowledge for the clinical entity "impotence" throughout the international scientific community. The society has over 2000 members worldwide, with five regional societies that are affiliated with ISSM: the Africa Gulf Society for Sexual Medicine, Asia Pacific Society for Sexual Medicine, European Society for Sexual Medicine, Latin American Society for Impotence and Sexuality Research, and Sexual Medicine Society of North America.
About Blackwell Publishing
Blackwell Publishing is the world's leading society publisher, partnering with more than 600 academic and professional societies. Blackwell publishes over 750 journals and 600 text and reference books annually, across a wide range of academic, medical, and professional subjects.
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