Viagra Used to Treat Congestive Heart Failure, Improves Quality of Life

March 11, 2004 — The combination of congestive heart failure and erectile dysfunction can often cause depression, but the drug, Viagra, can safely work to improve all three disorders, says a new study out of the University of Alberta.

Traditionally, sildenafil--also known as Viagra--was thought to be risky for patients with congestive heart failure (CHF) but the study led by researcher Linda Webster, from the Division of Cardiology, shows that not only is the drug safe but it makes the patients happier in all aspects of their lives. The study is the first of its kind to investigate the association between the treatment of erectile disfunction (ED) and depression.

"It seemed that when the men were able to perform and express themselves sexually, it positively impacted feelings about themselves, thoughts about how others viewed them, sleeping patterns, appetite, interest in activities, and, of course, interpersonal relations," said Webster, an advanced nurse practitioner whose master's thesis made up the research. The study is published in the Archives of Internal Medicine.

Fifty-two per cent of men aged 40 to 70 suffer from (ED) erectile dysfunction—the persistent inability to achieve and maintain an erection sufficient for satisfactory sexual performance. The mechanism of normal erection seems to be compromised with aging and vascular disease. In fact, the association between vascular disease and ED is so strong that ED has been proposed to be a marker of cardiovascular disease. Depression also fits so often into the puzzle that the three—depression, ED and cardiovascular disease—have been proposed to form a mutually reinforcing triad, say the authors.

"Congestive heart failure is difficult to live with in that they must take numerous medications, their activity is hindered because of shortness of breath and fatigue, and ultimately though treatable, there is no cure," said Webster. "The inability to perform sexually can cause depression alone and of itself."

The research team—Dr. Evangelos Michelakis and Websters supervisor Dr. Stephen Archer, from the Department of Medicine, and Dr. Terry Davis, from the Faculty of Nursing—ensured that participants first underwent an exercise stress test and take a first dose of Viagra in a clinic setting in order to monitor blood pressure response to be eligible for the study. They found that for those men with moderate to moderately severe CHF, Viagra is not only safe but it lowers blood pressure as well. It is less costly and is associated with fewer side affects than existing treatments for CHF.

Doctors have been hesitant to prescribe sildenafil to patients with CHF. When the drug first hit the market, some deaths were reported among heart patients. It was initially believed that having sex had proved to be too much for their damaged hearts but eventually it was determined the combination of sildenafil and nitroglycerine was responsible.

What Viagra does in the lungs, as in the penis, is expand the blood vessels. That helps an impotent man have an erection; it can also, it appears, make breathing easier for people with pulmonary hypertension.

The study was supported by a grant from the U of A Hospital Foundation. Drs. Michelakis and Archer are supported by the Alberta Heritage Foundation for Medical Research, Canadian Institutes of Health Research, the Heart and Stroke Foundation and the Canadian Foundation for Innovation.

This page reported by J. Strax March 11, 2004; last updated Aug 12, 2005

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