Sildenafil citrate is one of the frontline drugs used to manage erectile dysfunction (ED). Chemically, it is described as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H –pyrazolo [4,3-d]pyrimidin-5-yl)-4 ethoxyphenyl] sulfonyl]-4-methylpiperazine citrate (C22H30N6O4 S). It is a highly selective inhibitor of cyclic guanine monophosphate-specific phosphodiesterase type-5. There had been heightened concerns following reports that sildenafil citrate may increase the risk of cardiovascular events, particularly fatal arrhythmias, in patients with cardiovascular disease. So the cardiac electrophysiological effects of sildenafil citrate have been investigated extensively in both animal and clinical studies. This article ties up the various outcomes of the investigations with a view to guiding physicians and patients that use sildenafil citrate to manage erectile dysfunction, especially as it concerns its effect on their cardiovascular function in health and in disease. Sildenafil citrate could impact negatively on ailing hearts, but on a healthy heart, there may not be any such impact, rather, it improves on heart performance as it lowers the blood pressure.
Erectile dysfunction (ED) is a common disorder whose prevalence increases with age. Over time a strong correlation between erectile dysfunction and cardiovascular disease has been established as the result of the same pathophysiological process: endothelial dysfunction and atherosclerosis. Because small vessels of the penis can be affected by atherosclerotic plaque earlier than coronary arteries, carotids or femoral arteries, men often have symptoms of ED long before the signs of cardiovascular disease appear. For this reason, ED can act as a marker of early atherosclerosis that predicts the onset of cardiovascular disease at a later time.
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