American College of Cardiology/American Heart Association Guidelines on the Use of Sildenafil in Patients With Cardiovascular Disease

Abstract

The American College of Cardiology (ACC) and the American Heart Association (AHA) developed an Expert Consensus Document in 1999 on the use of sildenafil in patients with cardiovascular disease (1). This type of document is intended to inform practitioners, payers, and other interested parties of the opinion of the ACC concerning evolving areas of clinical practice and/or technologies that are widely available or are new to the practice community. Topics chosen for coverage by the Expert Consensus document are so designated because the evidence base and experience with the technology or clinical practice are not sufficiently well developed to be evaluated by the formal ACC/AHA Practice Guidelines process. This is an attempt to inform and guide clinical practice in areas in which vigorous evidence is not yet available. Sildenafil, a selective inhibitor of phosphodiesterase-5 (PDE5), became widely available in 1998 for the treatment of erectile dysfunction (ED). In response to inquiries from various parties about the safety of using sildenafil in patients with cardiovascular disease, the ACC leadership decided to develop an Expert Consensus Document on this topic. The writing committee members were selected for specific expertise in clinical cardiology, managed care, vascular reactivity, nitric oxide donors and pharmacology of antihypertensive agents. The AHA was invited to jointly author the document. After the document was developed, 10 external referees reviewed the text. The final document was approved by the ACC Board of Trustees and the AHA Scientific Advisory Committee and published in January 1999 (1).KeywordsErectile DysfunctionAmerican Heart AssociationPDE5 InhibitorChronic Heart Failure PatientAmerican Heart Association GuidelineThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.