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The January Journal of the American College of Cardiology contains an "expert consensus document," authored by representatives of the American College of Cardiology and the American Heart Association, on the use of sildenafil (Viagra) in patients with cardiovascular disease.
The document prohibits the use of sildenafil concurrently with nitrates, a point already well known. However, the drug is also noted to be "potentially hazardous" in (1) patients with stable coronary disease who are not taking nitrates; (2) patients with congestive heart failure and borderline low blood pressure; (3) patients on multidrug antihypertensive regimens; and (4) patients taking drugs that may prolong sildenafil's half-life (a long list is included in the artic…