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New Role of Viagra
Heart Booster:
Sildenafil (Viagra), the much-joked-about drug for erectile dysfunction (ED), is showing serious promise as an effective treatment for a variety of heart, lung and circulatory diseases.
How and why Viagra works
Viagra blocks an enzyme known as
phosphodiesterase 5 (PDE5A). This action causes levels of cyclic guanosine monophosphate (cGMP) to rise inside the smooth muscle cells lining veins and arteries. cGMP plays a central role in relaxing blood vessels; an increase in cGMP causes blood vessels to dilate (open).Interestingly, Viagra was developed to be a cardiac drug, and its ability to cause erections was an incidental finding. Because Viagra proved to have only modest blood pressure lowering effects, it was not expected to have any significant effect on the heart. Experience has proven this theory wrong, and the millions of men who use Viagra for ED have helped bring its cardiopulmonary benefits to light.
Following are some key findings of sildenafil (called Revatio for indications other than ED).
Giving oomph to failing hearts:
Sildenafil increases nitric oxide uptake, which is known to benefit patients with heart failure. In a double-blind, crossover study in Australia, 20 patients with Rejection fractions less than 35 percent given sildenafil improved the heart's performance even after heart failure medications were withheld for at least 12 hours.
Blunting the effects of stress on the
heart: One role of cGMP is to help prevent the heart muscle from growing large and weak in response to stress - a condition called cardiac hypertrophy, which can lead to heart failure. Researchers at 'Johns Hopkins University found that sildenafil prevented damage from occurring during drug-induced stress without affecting the heart at rest. This study underscored the importance of earlier research showing the same beneficial effect on hearts stressed by high blood pressure.Lowering pulmonary hypertension: Many diseases of the heart, lungs and connective tissues, including emphysema and chronic bronchitis, can cause blood pressure to rise in the main artery leading from the heart to the lungs. Symptoms include severe breathlessness and chest pain. This dangerous condition, known as pulmonary hypertension, is difficult to treat. In a double-blind study, European physicians gave various doses of sildenafil or
placebo for 12 weeks to 278 patients with pulmonary hypertension. At the end of this period, patients who took sildenafil were able to walk about 50 yards farther than those who took placebo. The 222 who continued on sildenafil for one year saw a significant drop in pulmonary arterial pressures and continued improvement in their ability to exercise, regardless of the dose of sildenafil they had been taking.In another study, which appeared in a recent issue of Cerebrovascular Disease, of 11 patients with severe pulmonary hypertension, sildenafil was found to improve blood flow to the brain by relaxing its veins and arteries. All in all, it appears that Viagra/Revatio may be just what the doctor orders for patients with a wide variety of serious conditions.