Viagra: Good for love, but good for the heart, too?

Posted: June 4, 2015

Viagra, the little blue pill that's improved the sex lives of millions, has warmed hearts worldwide given its success in the bedroom. But it may do more than bring hearts together – it may improve heart health, according to a study published in the journal BMC Medicine. That's because, as the study showed in men with varying degrees of heart failure, Viagra improved how well the heart pumped blood and reduced thickness of heart muscle on the heart's left ventricle, the part that does the most pumping. This thickening often is caused by high blood pressure and results in heart failure and angina. So, yes, reducing that thickness would be a good thing, according to Marshfield Clinic cardiologists.

Next steps

"It's an interesting study, but the next step is a large, randomized clinical trial," said Dr. Sanjay Kumar, a Marshfield Clinic cardiologist who specializes in electrophysiology or the heart's electrical system. "We have much research to do before we can conclusively say who, if anyone, would benefit from such a treatment for heart failure." Viagra, or sildenafil citrate, works by blocking an enzyme called PDE5. This enzyme prevents smooth muscle, found mostly in the penis and lungs, from relaxing. When Viagra goes to work, the muscle relaxes, allowing blood to flow easily. For years doctors have used sildenafil citrate to treat high blood pressure that affects the lungs, allowing for better blood flow. Now, as in this study, they're finding this enzyme that prevents relaxation is common in heart failure patients. Healthy hearts don't have this enzyme. Kumar said the study is most promising for patients who have diastolic heart failure, meaning their hearts don't function properly when they relax and fill with blood.

"We currently don't have a good medicine for diastolic heart failure," Kumar said. "A medication would be beneficial, therefore, we as doctors get excited when we see any data, such as in this study, that shows reduction in heart muscle thickness and improvement in efficiency."

However, the majority of patients who have diastolic heart failure are women and older adults, making a trial that includes women all that much more important, Kumar said.

Promising … to a point

This study is not void of criticism. Kumar said findings related to thickness of heart muscle and efficiency wasn't seen throughout all studies in the meta-analysis. So, while promising, researchers need the chance to dig deeper. "Still, it's promising. People who have a failing heart usually have thickened heart muscle so a medicine, such as this one, that may reduce thickening would be beneficial to patients," Kumar said. Get more information about heart disease from cardiology.