Sildenafil and cardiovascular events — drug interactions

Abstract

The most common cause of erectile dysfunction (ED) is vascular endothelial dysfunction [1]. Cardiovascular diseases share the same risk factors as ED — smoking, hyperlipidaemia, diabetes and hypertension — and the coexistence of a cardiac problem may cause concern with regard to advising on the treatment of ED (Fig. 1). This concern has increased with the realisation that ED is a marker for previously undetected coronary artery disease and the casual use of sildenafil without proper assessment — so-called ‘Internet sex’ — precipitating acute cardiac events [2, 3].