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Phosphodiesterase-5 inhibitors and their hemodynamic effects

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Abstract

Erectile dysfunction occurs commonly in untreated and treated hypertensive patients, impairing adherence to treatment and quality of life. Furthermore, it is a marker for enhanced risk for cardiovascular disease. Phosphodiesterase type 5 (PDE5) inhibitors, sildenafil, vardenafil, and tadalafil, provide effective treatment of erectile dysfunction. They reduce blood pressure in healthy patients: sildenafil 100 mg, -3.7/-3.6 mm Hg; vardenafil 20 mg, -7.5/-8 mm Hg; and tadalafil 20 mg,-1.6/-0.8 mm Hg. Greater declines in blood pressure with a PDE5 inhibitor may be observed in treated and untreated hypertensive patients. The additive effect of PDE5 inhibitors with one or multiple antihypertensive drugs is modest. α1-Blockers, except tamsulosin, may result in larger declines in blood pressure and cause orthostatic hypotension. Thus, caution should be exercised by using the lowest doses of α1-blockers and PDE5 inhibitors in combination. Nitrates in combination with PDE5 inhibitors cause a profound decline in blood pressure and are contraindicated.

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Authors and Affiliations

  1. Hypertension & Clinical Pharmacology, Medical College of Georgia, 1467 Harper Street, HB-2010, Medical College of Georgia, 30912-3105, Augusta, GA, USA

    L. Michael Prisant MD

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  1. L. Michael Prisant MD
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Correspondence to L. Michael Prisant MD.

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Prisant, L.M. Phosphodiesterase-5 inhibitors and their hemodynamic effects. Current Science Inc 8, 345–351 (2006). https://doi.org/10.1007/s11906-006-0075-y

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  • DOI: https://doi.org/10.1007/s11906-006-0075-y

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