Living Harder—and Now Longer—with Viagra

Do you know how Viagra got its start? Pfizer developed it to relieve a type of chest pain, angina, that’s associated with severe heart disease. They thought it might work better than nitrate paste or pills, the standard of the day. Guess what? It didn’t. But the men in the clinical trial wouldn’t give the pills back. “No way,” they said. “This stuff’s great.”

Give a Guy a Break

As a urologist alongside the clinical trial team headed by Dr. Tom Lue, as they begged men to return the study medication. It was like pulling teeth. And you can bet that anyone in the erection trial that followed knew right quick if they had gotten the placebo sugar pill or the real deal. And so was born the first of several erection wonder drugs known as the PDE5i’s.

Have a Heart

And now, as Viagra’s patent expires in 2020, and with cheaper copycats waiting to pounce on its turf, its glory days appear to be over.
Or are they?

What goes around comes around. Many of us in the sexual health field have thought that the PDE5is might be cardioprotective, kind of like the new aspirin. We know these drugs relax the smooth muscle in penile blood vessels, resulting in more blood flow and, Viola, an erection. But, they can also reliably lower the blood pressure in lungs  and, less reliably, in the general circulation of patients with hypertension. Now, who doesn’t want to live hard and live long? These pills are getting more likeable every day!

But it doesn’t stop there. Recently, Swedish researchers found that men taking PDE5i’s after having heart attacks lived longer than men who didn’t. In a massive national study of over 43,000 men with first time heart attacks, guys taking PDE5i’s after heart attacks lived 33% longer and experienced 40% fewer hospitalizations for heart disease that those who didn’t take these erection drugs. And, to boot, the longevity effect was dose dependent, meaning the higher the PDE5i dose the stronger the effect, always a good sign in epidemiology studies. Finally, other forms of erection medications showed no longevity benefit.
Lo and behold, Viagra and its compadres are on the verge of garnering even more respect than ever in medicine. One could debate the true value of treating penile erections in the world of medicine, but who would argue with heart attacks? So, it’s not only true that what happens to the penis happens later to the heart, but also what helps the penis also helps the heart.