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Senior Citizens With Heart Problems May Be Able to
Take Erectile Dysfunction Drugs
Study suggests replacing nitrate will allow the use
of ED drugs
June 28, 2005 – Men with heart problems can
substitute calcium antagonist or beta blocker for their oral nitrate
treatment and, for the first time, benefit safely from erectile
dysfunction drugs that restore function in 80 percent of men, according
to a study in England. Senior citizens are the primary group suffering
from both heart disease and erectile dysfunction.
Dr. Graham Jackson, a cardiologist 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 wanted 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, he added."
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," 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.
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