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Wednesday, 13 February, 2002, 00:15 GMT
Viagra 'no danger to heart'
Viagra pills
Viagra was hailed as a 'wonder drug' on its launch
Research has underlined the fact that the anti-impotence drug Viagra can be safely taken by men with heart disease.

When Viagra was launched, it was hailed as a major breakthrough in the treatment of impotence, but there were major question marks about whether men with heart disease could safely take it.

Studies have shown that men who take nitrates for their heart condition are at risk when they take Viagra because the combination of the two drugs can lead to serious decreases in coronary blood flow and blood pressure.

But this latest research shows that Viagra does not increase the risk of a heart attack in men with coronary heart disease, provided they are not taking nitrates.

Some doctors are over-cautious in their prescribing of Viagra

Ann Tailor, Impotence Association
Doctors are told not to prescribe Viagra - technical name sildenafil - for men taking nitrate drugs for heart conditions because it works in the same way as the anti-impotence drug and lowers their blood pressure.

Dr Patricia Pellikka, a Mayo Clinic cardiologist who led the study, said: "As a cardiologist, these findings increase my confidence in prescribing sildenafil, which can have important quality of life benefits for patients."

Impotence campaigners welcomed the US study as they called for the removal of NHS prescribing restrictions on erectile dysfunction treatments.

GPs are currently unable to prescribe treatments for the condition on the NHS for some men, including those with heart disease and depression.

Exercise test

Researchers monitored blood flow to the heart in the US study published in the Journal of the American Medical Association.

The study, funded by the American Heart Association and by Mayo Clinic, involved just over 100 men who had stable coronary artery disease.

Ultrasound images of the heart were recorded as the men pedalled on an exercise bike one hour after taking Viagra and during another session one hour after taking a sugar pill.

Exercise electrocardiograms - monitoring the rhythm and electrical activity of the heart - were also taken.

Dr Pellikka said: "In these patients, sildenafil had no adverse effect on symptoms or how long the men were able to exercise.

"We expected and saw that echocardiograms of these heart disease patients would show evidence of inadequate blood supply to the heart muscle during exercise.

"The key finding, however, is that the problem was not made worse by sildenafil."

'Increased confidence'

Dr Pellikka says although the study was not a large enough number to absolutely predict cardiac events, its overall message was that Viagra did not increase oxygen deprivation to the heart.

A British Heart Foundation spokeswoman said although Viagra had proved safe and effective for thousands of men with erectile dysfunction, some doctors had been cautious about prescribing it to men with coronary heart disease, heart failure or those taking several medications for the treatment of high blood pressure.

She added: "This research is encouraging because it may mean that some men who have been advised against taking sildenafil may one day be able to benefit from it after taking their doctor's advice."

'Remove restrictions'

Ann Tailor, director of the Impotence Association, told BBC News Online the drug's own guidance said only men who had recently suffered heart attacks, was taking nitrates or had such a serious heart condition that they should not be having intercourse, should not be given Viagra.

An Impotence Association survey of 2,000 people affected by impotence found 94% believe all couples who are unable to have sex because of erectile dysfunction (ED) should be able to get NHS help.

She called for the Department of Health's prescribing restrictions on all treatments for ED should be removed, and the devastating effects of the condition recognised.

Dr Ian Banks, president of the Men's Health Forum added: "This is an essential campaign to highlight to the government the benefits that effective treatment of ED and other sexual conditions can have on the overall well-being of men and their partners."

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