Q: Can men with heart disease safely take Viagra?

A: Viagra (sildenafil) and similar medications are used by many men for the treatment of erectile dysfunction. Many men with heart disease can safely take these medications. Sildenafil is a vasodilator (dilates blood vessels). As such, it can lower blood pressure. In the majority of men with heart disease, including most of those being treated with antihyper-tensive drugs, this is not a problem. When sildenafil is combined with nitrates (a class of medications often used in heart disease), the combined vasodilating effects of these medications can lead to severe hypotension (low blood pressure) and syncope (fainting). Men taking nitrates for coronary artery disease should never take sildenafil or similar medications. Others who should avoid these medications are those with severe congestive heart failure who already have low blood pressure and patients with unstable cardiac symptoms, including chest pain, shortness of breath and dizziness. Fortunately, sildenafil is safe for men with stable coronary artery disease who are not taking nitrates. Talk to your doctor to see if these medications are right for you.

-- Dr. C. Samuel Ledford, Chattanooga Heart Institute; member, Chattanooga/Hamilton County Medical Society

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