#AskDrKK: Can patient with high blood pressure take Viagra group of drugs?

#DrKKAnswers:
Viagra group of drugs are typically well tolerated with only minor reductions in blood pressure in patients taking conventional antihypertensive drugs (ACE inhibitors, AR blockers, calcium blockers, beta blockers, and diuretics), even when used in combination.
Source:
1. Sildenafil Study Group. Am J Hypertens 2001; 14:70.
2. Am J Hypertens 2004; 17:1135.

#AskDrKK:Can heart patients take Viagra group of drugs Vardenafil and tadalafil?

#DrKKAnswers:
Tadalafil has the advantage of a longer duration of action.
Both drugs and sildenafil potentiate the BP lowering response to nitrates. This interaction lasts 24 hours with vardenafil and up to 48 hours with tadalafil.
Tadalafil, vardenafil and sildenafil are contraindicated with concomitant nitrate use.

#AskDrKK:Can heart patients take Viagra or Sildenafil?

#DrKKAnswers:
Sildenafil improves erectile function in patients with stable heart blockages. It is also effective in patients with hypertension, diabetes, and nonvascular organic or psychogenic causes for erectile dysfunction.
However it can lower blood pressure and interact with nitrates.
It lowers the systolic upper blood pressure by about 8 mmHg.
The BP lowering is not more when given with amlodipine.
Sildenafil also improves endothelial dysfunction and inhibits platelet activation.

#AskDrKK: Can Sildenafil (Viagra) cause acute heart attack?

#DrKKAnswers:
1. Acute heart attack and sudden death have been described after sildenafil therapy [1, 2].
2. Seventy percent of the men who developed MI of SCD had known cardiovascular disease and several were using a nitrate concurrently with sildenafil [3].

References
1. Lancet 1998; 352:957.
2. N Engl J Med 1999; 341:700 .
3. Circulation 2000; 102:2516.