Sildenafil and Heart

Q: Sildenafil may have an antiplatelet effect.

A) True

B) False

Answer: A

Sildenafil exerts its mild antianginal effect via four mechanisms:

• It lowers the systolic blood pressure by approximately 8-10 mmHg 
• Dilation of epicardial coronary arteries
• Improving endothelial dysfunction, and 
• Inhibiting platelet activation

That said, all patients with cardiovascular disease should use sildenafil after risk-stratification and under the care of a physician, as its vasodilatory effect can be detrimental in some patients, particularly with undiagnosed or underlying Aortic Stenosis (AS).

#cardiology

#pharmacology

References:

1. Levine GN, Steinke EE, Bakaeen FG, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2012; 125:1058.

2. Herrmann HC, Chang G, Klugherz BD, Mahoney PD. Hemodynamic effects of sildenafil in men with severe coronary artery disease. N Engl J Med 2000; 342:1622.

3. Halcox JP, Nour KR, Zalos G, et al. The effect of sildenafil on human vascular function, platelet activation, and myocardial ischemia. J Am Coll Cardiol 2002; 40:1232.

4. Mittleman MA, Maclure M, Glasser DB. Evaluation of acute risk for myocardial infarction in men treated with sildenafil citrate. Am J Cardiol 2005; 96:443.