Sildenafil (ie Viagra) Boosts Your Heart as Well as Your Love Life:
So Why do Doctors and Drug Companies Want this to be a Secret?
For those who know the history and science of Viagra/Cialis/Levitra, the nitric oxide boost from these drugs that delivers blood flow to the penis was originally designed to improve heart health and general vascular flow. During the Covid-19 epidemic, it was theorized that the Sildenafil family of drugs (the generic name of these ED drugs) was effective in restoring epithelial cell (those that line blood vessels) health. Hikers and long-distance swimmers know that Sildenafil combats the dangers of pulmonary edema. So why are all these secondary Sildenafil health benefits kept a secret by Doctors and drug companies?
The History of Sildenafil: Sildenafil was discovered by accident in the late 80s by Pfizer scientists who were working on drugs to combat hypertension (high blood pressure) and angina (low blood oxygen delivery to the heart). It had been known since the late 1800s that nitroglycerin offset angina (it delivered NO, nitric oxide, to the vascular system, which “relaxes” the endothelial cells lining our veins, thereby lowering blood pressure, increasing blood flow, and raising blood oxygen). Though not producing NO directly, Sildenafil affects signaling pathways that relax blood-vessels, particularly dilating those in the lungs and affecting the penis. Though Sildenafil was found to be marginally effective in treating angina, researchers soon learned that it produced powerful erections in clinical trials. It did not increase sexual arousal per se, but counteracted erectile disfunction by increasing blood flow. It has been theorized that the “structural” benefits of Sildenafil in turn may have increased arousal by boosting male sexual confidence. Subsequent studies have shown Sildenafil to be relatively safe, with common side-effect warnings of headache and heartburn, rare side-effects of vision/hearing loss and prolonged erection. It cannot be taken with nitroglycerin drugs as the two together can “overrelax” blood vessels resulting in dangerously low blood pressure (hypotension). Studies have been done on Sildenafil use in women, but have been inconclusive. Though increased blood flow to female genitalia is thought to be a positive, Sildenafil once again does not help with sexual arousal, nor with dryness (which is a primary challenge involving sex in elderly women). (Anderson,2023), (Perez, 2023)
Off-Label Uses for Sildenafil: Though not entirely proven and clinical-trialed by the pharmaceutical/medical community, Sildenafil has many off-label uses. All of this implies that nitric oxide release/relaxation of epithelial cells in blood vessels has broad benefits, especially in the elderly:
1) Benign Prostate Hyperplasia (BPH): It has recently been established that many older men with high PSA results (the main marker for prostate cancer) may be getting a “false positive” due to Benign Prostate Hyperplasia (BPH), a temporary enlargement of the prostate. This enlargement may be due to several factors, mostly temporary infections or irritations (such as those experienced by cyclists who can injure their prostate). In any case, Sildenafil is known to offset BPH, possibly by the same mechanisms that increase blood flow to the penis (increased blood flow to the prostate?) This is currently an off-label use, but one that has been fairly well studied and substantiated. (health.harvard.edu, 2011)
2) Pulmonary Edema: Though still rather poorly understood, some long distance swimmers and high elevation climbers are subject to pulmonary edema. This is a condition in which low oxygen levels, high blood pressure, vascular constriction, cold temperatures (or all of the above) cause some individuals to have blood back-up into the alveoli sacs of the lungs, causing them to cough-up blood and sometimes perish. Swimmers have given this a unique name called SIPE (Swimming Induced Pulmonary Edema). With high altitude climbers, the condition is known as HAPE (High Altitude Pulmonary Edema). Sildenafil is known to at least partially prevent these conditions, perhaps by relaxing the blood vessels as mentioned previously. This is another “off label” use, but one sworn to by adventurous triathletes and the like. (Moon, 2019), (Doheny, 2004)
3) Covid-19: The first wave of Covid-19 notoriously caused patient’s blood oxygen levels to drop to dangerous levels (below 89%). It was theorized that Covid-19 attacked the endothelial cells lining our blood vessels, thereby lowering blood flow and delivery of oxygen by red blood cells/hemoglobin. Sildenafil was suggested as a remedy, since as previously stated, it relaxes blood vessels and increases blood flow and blood oxygen levels (similar actually to how it works for a high-altitude climber with low blood oxygen). Though not producing nitric oxide directly (NO was another suggested Covid-19 remedy), Sildenafil made enhanced NO delivery possible. Since the first wave of Covid-19 in 2021, the virus has mutated into more benign forms (more infectious but less deadly, in particular having less effect on blood oxygen levels). Anti-virals have also been used quite effectively against the virus. However, the low-blood oxygen of several early patients (and the lack of hospital beds and ventilators) should serve as a suggestion that if another, similar epidemic rages, Sildenafil may be a way to lessen hospital loads and decrease ventilator use. (health-desk.org, 2022)
4) General Heart and Vascular Health: This may be the big one (so to speak, a little Viagra humor here)…studies show that men using Sildenafil long-term may cut their overall heart disease risk by 25%, specifically including the following:
a) 39% lower risk of death due to heart disease
b) 22% lower risk of death due to angina
c) 17% lower risk of heart failure
d) 15% lower need for angioplasty
e) 13% lower rate of major events such as heart attack or stroke
5) Sildenafil may lower Alzheimer’s Risk: Some recent studies have stated that Sildenafil may lower Alzheimer’s risk by as much as 69% (based upon insurance claims from over 7 million men). (nih.gov,2021)
6) A Final Note on Sildenafil for Women: In mouse studies, Estrogen provided a vascular relaxing benefit similar to Sildenafil though the action of a related nucleotide called cGMP. This may explain why women tend to have cardiac events later in life than men (their vascular systems are “relaxed” until after menopause). If true, then this may be all the more reason for elderly women to take Sildenafil, unless on hormone-replacement. (Takimoto, 2014)
To be fair, these studies are ongoing, and not all agree with these results (more studies are needed). However, even if partially true, these results are rather eye-popping, and suggest that “relaxed blood vessels” are not only a great thing for elderly men, but certainly women too (plus, woo-hoo! What a fun way to take your medicine!)
Other studies show that Sildenafil increases exercise tolerance also, but a sidebar is that Sildenafil is actually quite well tolerated (in other words, it has few side effects). There is the stated rare Reynaud’s Syndrome (a loss of blood flow to extremities in cold weather), occasional hearing/vision loss, but with all these old men taking Sildenafil the past 30 years, quite a remarkable track record for safety/efficacy/lack of side effects. Quite a wonder-drug, really. Rauf, 2023), (NBCNews.com, 2014)
Which Leads us to the Question, Why Does the Medical/Pharmaceutical Community Not Prescribe More Sildenafil: Not pointing any fingers here (or drumming up conspiracy theories), but if something is as effective as Sildenafil (especially for seniors), then why is it not more liberally prescribed?
1) The first answer we get is the “we need more studies to determine Sildenafil’s efficacy for _____”. This is kind of laughable since once Sildenafil was found to give men large hard-ons in the late 80s, it was almost immediately put on the market after quick clinical trials, which fortunately demonstrated that it had few side effects. Since that time, men have been using the drug massively, FURTHER proving the efficacy and low-side effects of not only anti-ED, but also these other off-label uses. This all begs the question, “why not prescribe for all elderly men and women, as a kind of vitamin” (haha, I know its too powerful to get over the counter, but shouldn’t it at least be widely prescribed, like Statins?)
2) Statins…ah ha! I don’t have hard (so to speak) answers here, but more my own theories. In addition to Sildenafil being one of Pfizer’s blockbuster, profitable drugs, their statin Lipitor (available since 1996), is another big money maker. It is somewhat well-known in the medical community that the heart attack/stroke epidemic had more to do with inflammation and vascular constriction than fatty “cholesterol” clogging arteries. Statins act as anti-inflammatories in addition to lowering cholesterol, so they have all bases covered. However, Pfizer may have a business interest in compartmentalizing pills for “Erectile Disfunction” and “Heart Attack/Stroke”, since they can sell more pills that way (God forbid that one pill could do both, which leads us back to Sildenafil). Could Sildenafil and a reasonable amount of diet/exercise allow a senior to abandon statins? (which can be hard on your liver) I certainly think so, and I suppose Pfizer doesn’t want you to know that! (Herman,2019)
Other Vern Scott articles about Senior health you may enjoy:
