Abstract
After sildenafil was launched in 1998, there were numerous reports about deaths that were associated with its use particularly in men with cardiovascular diseases. These reports have raised serious concerns about the cardiovascular safety of PDE5 inhibitors, and several investigations have addressed this issue in the past few years. These studies have concordantly shown that the use of sildenafil is safe in patients with stable cardiac diseases. However, when cardiovascular safety of sildenafil use in clinical practice is considered, several issues have to be taken into account. These include (i) the co-morbidity of erectile dysfunction (ED) and cardiovascular diseases, (ii) the risk of sexual intercourse itself in patients with heart disease, (iii) the efficacy and possible adverse effects of ED treatment with PDE5 inhibitors in patients with specific cardiovascular diseases, (iv) interactions between PDE5 inhibitors and cardiovascular drugs, and (v) the influence of PDE5 inhibitor use on cardiovascular mortality.
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