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Men with heart failure often have erectile dysfunction, in part related to vascular comorbidities, medication use, and depression. Despite the ACC-AHA position that heart failure is a relative contraindication for use of sildenafil (Viagra), researchers hypothesized that heart failure patients without ischemia or need for nitrates could be candidates for drug treatment of erectile dysfunction.
In a randomized trial, 35 men with nonischemic heart failure and chronic erectile dysfunction who were not taking nitrates received 50-mg sildenafil (maximum use, once daily) or placebo for 6 weeks; for the next 6 weeks, subjects were crossed over to the other treatment. Twenty-four participants (69%) had hypertension.
Safety and tolerability were estab…