Does the Combined Use of PDE5i and Nitrates Increase Mortality Risk in CVD Patients?

Erectile dysfunction treatment with phosphodiesterase-5 inhibitors is known to reduce mortality risk in patients with myocardial infarction (MI). 1 The prescription of PDE5is and nitrates to patients with cardiovascular disease (CVD) is increasing despite the risk of developing hypotension. A study has now investigated the effect of the combined use of PDE5is and nitrates in men with MI or revascularization.

2 In the study, the combined use of PDE5i and nitrates increased the risk of cardiac revascularization (hazard ratio [HR] – 1.95), MI (HR – 1.72), major cardiovascular events (HR – 1.70), heart failure (HR – 1.67), non-cardiovascular mortality (HR: 1.40), overall mortality (HR: 1.39), and cardiovascular mortality (HR: 1.34) in men with stable coronary artery disease (n = 5,710) compared to men who received nitrates alone (n = 55,777). The study suggests a patient-centric evaluation…