Viagra – Beating the dead horse

This week I will detour from my usual topic of sexually transmitted infections to talk about Viagra. I call it “beating the dead horse,” because Viagra can beat a dead “horse” to life and me talking of this issue again amounts to the third time in the last year that I am addressing this issue.{{more}}

Every week I see at least 10 men in my office with a new onset of impotence. After going though a thorough history and physical examination, I will usually suggest the use of Viagra or one of its brothers and the usual response is “No doc, I don’t want a heart attack” or some form of fear about a heart attack. The problem is not just fear, but misinformation. Ever since Viagra was released on the US market in 1998, there have been reports of heart attack following its use. All the studies have identified 1 (one) group of men who are at risk. These are the men who already have debilitating heart disease, so they are usually advised by their doctors to avoid all form of excessive physical activity and stress. These are the men who cannot walk 200 yards without resting; they are usually short of breath, look weak and sometime swollen. They have pre-existing heart disease. These men, on using Viagra, suffer a heart attack, not from the Viagra, per se, but from the physical activity of sex. Some of these men may have a sudden heart attack because the one group of medication that is used to treat their weak heart interacts with the Viagra to drop their blood pressure so low that it gives them a heart attack or stroke. This is because their hearts are weak and it cannot compensate to ”pick up” the blood pressure when it drops too low. Normal persons who experience a little drop in the blood pressure can compensate, but people whose hearts are so bad that they are taking these types of “heart tablets” cannot. These old men will suffer a sudden drop in the blood pressure and a heart attack the first or second time they use Viagra. They will not be using it over and over again and then suffer a heart attack, as has been rumoured about several individuals in this country.

To summarize, Viagra is safe; it can be used in 99% of men without problems. The 1% of men who cannot use it know themselves, as they know they already have bad heart disease and should not be exerting themselves. They know they will get a heart attack from almost any extreme physical activity, including sex, which in heart terms is an extreme form of cardiac activity.

Actually, Viagra was first investigated for treating people with chest pain from heart disease (called angina) and hypertension. It was during the trials for this problem that the old men with heart disease reported that they were getting erections they had not had in a long time. The study for the chest pain and high blood pressure was cut short, because the investigators were not getting the results they expected and the erection study was started. This study was an overwhelming success and in 1996, Viagra was approved for use in the UK (where the studies were first done) and subsequently in the US in 1998. Since then over 1.25 billion prescriptions have been written.

Viagra is still used to treat people with heart disease, but a special type. It is used to treat people whose right side of the heart is stressed or enlarged from pulmonary hypertension (high blood pressure in the lungs). It is also used to treat people who work and train at high altitudes and who suffer from altitude sickness, as it helps to reduce the high pressure in the lungs caused by the high altitude. The US is presently using it with their soldiers in Afghanistan. Viagra is also used to enhance performance in athletes, as it improves the blood flow to the lungs. The IOC is considering placing it on its list of banned substances because of this. Viagra is also being studied in people who have just had heart attacks, but who are not on nitrates. It is supposed to improve the blood supply to the heart, by allowing new blood vessels to reform after a heart attack.

The conclusion is Viagra is safe. It will actually strengthen, not weaken, the heart. It actually increases sexual and physical performance. The rumours surrounding Viagra in this country are as it is said, just rumours.

For comments or question contact:
Dr. Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com