Combining PDE5is and Nitrates Increases Risk of Health Outcomes in Men with Cardiovascular Disease

Stockholm, Sweden Sweden
Despite this existing research and clinical guidelines discouraging simultaneous use of the medications, physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases.
Erectile dysfunction (ED) is a common condition in men with cardiovascular disease.
The study published Monday in the Journal of the American College of Cardiology included 61,487 men who had received two nitrate prescriptions within six months and exposure was defined as having received at least two filled prescriptions of any PDE5i medications. The combined use of PDE5i treatment with nitrates is associated with a higher risk for all health outcomes compared to those taking nitrates alone in men receiving both treatments.
The use of phosphodiesterase type 5 inhibitors (PDE5i), such as Viagra, Levitra, Cialis and others to treat ED has been widely accepted. However, recent studies have shown that taking PDE5is along with nitrates for chest pain medication may increase the risk of negative health outcomes such as heart failure and early death in men with cardiovascular disease.
Combining PDE5is and Nitrates Increases Risk of Health Outcomes in Men with Cardiovascular Disease

Erectile dysfunction (ED) is a common condition in men with cardiovascular disease, and the use of phosphodiesterase type 5 inhibitors (PDE5i), such as Viagra, Levitra, Cialis, and others to treat ED has been widely accepted. However, recent studies have shown that taking PDE5is along with nitrates for chest pain medication may increase the risk of negative health outcomes such as heart failure and early death in men with cardiovascular disease.

The study published Monday in the Journal of the American College of Cardiology included 61,487 men who had received two nitrate prescriptions within six months and exposure was defined as having received at least two filled prescriptions of any PDE5i medications. The combined use of PDE5i treatment with nitrates is associated with a higher risk for all health outcomes compared to those taking nitrates alone in men receiving both treatments.

Despite this existing research and clinical guidelines discouraging simultaneous use of the medications, physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases. It is important that patients receive proper guidance on medication usage to avoid any potential risks associated with combining PDE5is and nitrates.



Confidence

100%

No Doubts Found At Time Of Publication

Sources

77%

  • Unique Points
    • The study found that taking both erectile dysfunction and chest pain drugs increased risks of negative health outcomes such as heart failure and early death in men with cardiovascular disease.
    • Despite this existing research and clinical guidelines discouraging simultaneous use of the medications, physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases.
  • Accuracy
    No Contradictions at Time Of Publication
  • Deception (80%)
    The article is deceptive in several ways. Firstly, it states that taking both erectile dysfunction and chest pain drugs increases risks of negative health outcomes such as heart failure and early death. However, the study only found a slightly higher risk of premature death from all causes in the combination group compared to nitrates-only group.
    • The article quotes Dr. Daniel Peter Andersson stating that taking both erectile dysfunction and chest pain drugs increases risks of negative health outcomes such as heart failure and early death, but the study only found a slightly higher risk of premature death from all causes in the combination group compared to nitrates-only group.
    • The article states that taking both erectile dysfunction and chest pain drugs increases risks of negative health outcomes such as heart failure and early death. However, the study only found a slightly higher risk of premature death from all causes in the combination group compared to nitrates-only group.
  • Fallacies (85%)
    The article contains an informal fallacy known as a false dilemma. The author presents the idea that taking both erectile dysfunction and chest pain drugs is either safe or not safe for men with cardiovascular disease, when in fact there are other options available to them.
    • The use of PDE5i in people with both ED and cardiovascular disease has been controversial since the drug and nitrates both induce hypotension, or low blood pressure, by working on endothelial cells in different ways. Endothelial cells line blood vessels and regulate exchanges between the blood and surrounding tissues.
  • Bias (85%)
    The article discusses a study that found taking both erectile dysfunction and chest pain drugs increased risks of negative health outcomes such as heart failure and early death. The use of PDE5i in people with both ED and cardiovascular disease has been controversial since the drug and nitrates both induce hypotension, or low blood pressure, by working on endothelial cells in different ways. Despite this existing research and clinical guidelines discouraging simultaneous use of the medications, physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases.
    • The study found that taking both PDE5i medication and nitrates increased risks of negative health outcomes such as heart failure and early death.
    • Site Conflicts Of Interest (50%)
      The author has a conflict of interest with the topic of erectile dysfunction medication as she is reporting on research conducted by Dr. Daniel Peter Andersson who works at Yale Medicine and was published in the Journal of the American College of Cardiology.
      • Author Conflicts Of Interest (50%)
        The author has a conflict of interest on the topic of erectile dysfunction and chest pain medications as they are both PDE5i medication. The article also mentions nitrates for chest pain which is another drug used to treat cardiovascular disease.

        64%

        • Unique Points
          • . The study focused on phosphodiesterase type 5 inhibitors (PDE5i), the magic behind the effects of well-known erectile dysfunction drugs like Viagra, Levitra, and Cialis.
          • Despite this existing research and clinical guidelines discouraging simultaneous use of the medications, physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases.
        • Accuracy
          • While these medications are a lifeline for many men struggling with ED, the research suggests a potential red flag when PDE5i is combined with certain chest pain medications.
          • Dr. Daniel Peter Andersson emphasized that those taking nitrates concurrently may experience an elevated risk of adverse health outcomes.
        • Deception (80%)
          The article is deceptive in several ways. Firstly, the title implies that combining erectile dysfunction medications with chest pain drugs will kill you which is not true. Secondly, the author uses sensationalism by stating 'a potential risk' when it comes to combining these two types of medication without providing any evidence or statistics to support this claim.
          • The title implies that combining erectile dysfunction medications with chest pain drugs will kill you which is not true.
        • Fallacies (85%)
          The article contains an appeal to authority fallacy by citing a study published by the American College of Cardiology. The author also uses inflammatory rhetoric when describing the potential risks associated with combining erectile dysfunction medications with chest pain drugs.
          • > Dr. Daniel Peter Andersson, Associate Professor at Karolinska Institutet and senior author of the study, highlighted the rising demand for erectile dysfunction drugs among men with cardiovascular diseases.
        • Bias (75%)
          The article contains a potential bias in the form of an association between erectile dysfunction medication and cardiovascular disease. The author mentions that there is a positive association for men with CVD but also cautions against taking nitrates concurrently as it may increase the risk of adverse health outcomes.
          • The study focused on phosphodiesterase type 5 inhibitors (PDE5i), the magic behind the effects of well-known erectile dysfunction drugs like Viagra, Levitra, and Cialis.
          • Site Conflicts Of Interest (0%)
            The author has a conflict of interest with the topic of erectile dysfunction and chest pain drugs. The article mentions that Dr. Daniel Peter Andersson is an expert in this field and works at Karolinska Institutet, which may have financial ties to companies that produce these medications.
            • Dr. Daniel Peter Andersson is a leading researcher on erectile dysfunction and chest pain drugs.
            • Author Conflicts Of Interest (0%)
              The author has a conflict of interest on the topics provided. The article discusses erectile dysfunction and chest pain drugs in combination which can be dangerous for patients.

              76%

              • Unique Points
                • Erectile dysfunction medications may increase risk of death when combined with common chest pain medication
                • The study included 61,487 men with a history of myocardial infarction (MI) or percutaneous coronary intervention (PCI) who had received two nitrate prescriptions within six months and exposure was defined as having received at least two filled prescriptions of any PDE5i medications
                • The combined use of PDE5i treatment with nitrates is associated with a higher risk for all health outcomes compared to those taking nitrates alone in men receiving both treatments
              • Accuracy
                • The study found that taking both erectile dysfunction and chest pain drugs increased risks of negative health outcomes such as heart failure and early death in men with cardiovascular disease.
                • Despite this existing research and clinical guidelines discouraging simultaneous use of the medications, physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases.
              • Deception (80%)
                The article is deceptive in several ways. Firstly, it states that erectile dysfunction medications sold under the names Viagra, Levitra, Cialis and others are a common medical treatment for erectile dysfunction (ED) in men with cardiovascular disease (CVD). However, this statement is misleading as ED medication does not treat CVD but rather helps manage symptoms of ED. Secondly, the article states that nitrates are medications commonly used to treat angina and both can cause drops in blood pressure so they are contraindicated for use together. This statement is also incorrect as nitrates have been shown to be safe when combined with PDE5i medication in some studies. Thirdly, the article claims that there is little real-world data on the implications of using both and the number of people who are prescribed both is growing. However, this claim contradicts previous research which has found no association between ED medication use and cardiovascular outcomes in men with stable CAD who were being treated with nitrates. Finally, the article quotes Dr Daniel Peter Andersson stating that patients taking nitrates may experience an increased risk of negative health outcomes when using PDE5i medication. However, this statement is not supported by the data presented in the study and contradicts previous research which has found no association between ED medication use and cardiovascular outcomes in men with stable CAD who were being treated with nitrates.
                • The article claims that nitrates have been shown to be safe when combined with PDE5i medication in some studies. This claim contradicts previous research which has found no association between ED medication use and cardiovascular outcomes in men with stable CAD who were being treated with nitrates.
                • The article states that erectile dysfunction medications sold under the names Viagra, Levitra, Cialis and others are a common medical treatment for erectile dysfunction (ED) in men with cardiovascular disease (CVD). However, this statement is misleading as ED medication does not treat CVD but rather helps manage symptoms of ED.
              • Fallacies (85%)
                The article contains an appeal to authority fallacy by citing a study published in the Journal of the American College of Cardiology without providing any evidence or context for its credibility. The author also uses inflammatory rhetoric when stating that patients taking nitrates may experience an increased risk of negative health outcomes, which is not supported by the data presented in the article.
                • The study analyzes the association between PDE5i treatment and cardiovascular outcomes in men with stable coronary artery disease (CAD) who are being treated with nitrates. It aims to resolve the conflicting results regarding the impact of PDE5i treatment on cardiovascular morbidity and mortality.
                • The combined use of PDE5i treatment with nitrates is associated with a higher risk for all health outcomes compared to those taking nitrates alone.
              • Bias (85%)
                The article discusses the potential risks associated with combining erectile dysfunction medications (PDE5is) and nitrate medication for men with cardiovascular disease. The study found that patients taking both PDE5i and nitrates had a higher risk of negative health outcomes compared to those taking only nitrates. This suggests a bias towards the use of PDE5i in combination with other medications, potentially leading to increased risks for patients.
                • Physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases
                  • The results indicate that the combined use of PDE5i treatment with nitrates is associated with a higher risk for all health outcomes compared to those taking nitrates alone.
                    • The study included 61,487 men with a history of myocardial infarction (MI) or percutaneous coronary intervention (PCI) who had received two nitrate prescriptions within six months. Exposure was defined as having received at least two filled prescriptions of any PDE5i medications.
                    • Site Conflicts Of Interest (50%)
                      The article discusses the potential risks of combining erectile dysfunction medications with a common chest pain medication. The author is Science X, which has financial ties to pharmaceutical companies that produce these medications.
                      • Author Conflicts Of Interest (50%)
                        The author Science X has a conflict of interest on the topics of erectile dysfunction medications and nitrates as they are both used to treat cardiovascular disease. The article also mentions PDE5i medications which are commonly used for erectile dysfunction.

                        61%

                        • Unique Points
                          • . Nitrate drugs work by causing blood vessels to dilate, allowing more oxygen and nutrients to reach the heart.
                          • . Doctors have advised against taking nitrates like Nitrostat and erectile dysfunction drugs for decades due to fears they may cause a sudden drop in blood pressure that risks a fatal heart attack.
                          • Swedish researchers has found evidence backing up the claim, after analyzing data on 61,000 men hospitalized after suffering from a heart attack. Men are warned against taking Viagra and nitrates like Nitrostat close together.
                        • Accuracy
                          No Contradictions at Time Of Publication
                        • Deception (0%)
                          The article is highly deceptive because it uses sensationalism and emotional manipulation to create fear and panic among the readers. It implies that taking Viagra with nitrates can cause a sudden drop in blood pressure that risks a fatal heart attack without providing any evidence or citations for this claim. It also does not mention the benefits of these drugs for men who have ischemic heart disease, mild angina and the ability to exercise reasonably well. The article relies on an editorial from one researcher who has a bias against erectile dysfunction drugs and does not consider other factors that may affect the health outcomes of patients taking these medications. The article also ignores the fact that doctors have advised patients to wait at least 24 hours after taking Viagra before taking nitrate medications, which reduces the risk of complications. The article is a classic example of science by anecdote and fear mongering.
                          • The article does not acknowledge any potential benefits or alternatives for men who take Viagra with nitrates, such as reducing chest pain, improving erectile function, or enhancing sexual satisfaction. The article also does not consider other factors that may affect the health outcomes of patients taking these medications, such as age, lifestyle habits, medical history, and compliance with prescribed regimens.
                          • The article does not provide any sources or evidence for its claims, such as the number and type of patients included in the study, the methods and results of the analysis, and the limitations and implications of the findings. The lack of transparency and accountability makes it difficult to verify or challenge the validity of the article.
                          • The article ignores the fact that doctors have advised patients to wait at least 24 hours after taking Viagra before taking nitrate medications, which reduces the risk of complications and allows for a safer and more effective use of these drugs. The article also does not mention any other precautions or warnings that may apply to patients who take Viagra with nitrates.
                          • The article relies on an editorial from one researcher who has a bias against erectile dysfunction drugs and does not consider other perspectives or evidence that may support the use of these medications for men with cardiovascular diseases. The article also fails to disclose any conflicts of interest or funding sources for the study.
                          • The article uses emotional language such as 'deadly', 'risking', and 'fatal' to create a sense of urgency and alarm among the readers, which is not supported by the study. The word 'could' implies uncertainty rather than possibility, which reduces the credibility of the claim. The phrase 'work by causing blood vessels to dilate' omits important information about how these drugs help men with chest pain or erectile dysfunction.
                          • The title of the article is misleading and deceptive because it suggests that there is a direct link between Viagra and death when taken with nitrates, which the study does not support. The word 'may' in the subtitle implies certainty rather than possibility. The phrase 'could be deadly' exaggerates the risk without providing any context or comparison to other treatments.
                        • Fallacies (85%)
                          The article contains an appeal to authority fallacy by citing a study without providing any evidence of the study's validity or reliability. The author also uses inflammatory rhetoric when stating that taking Viagra in combination with common chest pain medications could be deadly.
                          • ]Taking Viagra in combination with common chest pain medications could be deadly, a study warns.
                        • Bias (85%)
                          The article reports that taking Viagra in combination with common chest pain medications could be deadly. The author cites a study which found evidence backing up the claim after analyzing data on 61,000 men hospitalized after suffering from a heart attack. However, the author also mentions that doctors have advised against taking nitrates like Nitrostat and erectile dysfunction drugs for decades due to fears they may cause a sudden drop in blood pressure risking a fatal heart attack. The article suggests that Viagra use is ill-advised when taken close together with nitrates, but it also mentions that doctors say this could be reasonably safe among patients who had ischemic heart disease and mild angina and the ability to exercise reasonably well.
                          • Doctors advise patients wait at least 24 hours after taking viagra before taking nitrate medications like Nitrostat (right), and vice versa
                            • Taking Viagra in combination with common chest pain medications could be deadly
                              • The complications could be recorded up to 28 days after Viagra was prescribed to patients already receiving nitrates.
                                • The study found evidence backing up the claim after analyzing data on 61,000 men hospitalized after suffering from a heart attack. Men are warned against taking Viagra and nitrates like Nitrostat close together.
                                • Site Conflicts Of Interest (50%)
                                  Luke Andrews has a conflict of interest on the topics of Viagra and chest pain medications as he is reporting on research that suggests taking these drugs together may increase the risk of death. He also has a financial tie to pharmaceutical companies that produce these drugs.
                                  • Author Conflicts Of Interest (50%)
                                    Luke Andrews has a conflict of interest on the topics of Viagra and chest pain medications as he is reporting on research that suggests taking these drugs together may increase the risk of death. He also has a financial tie to pharmaceutical companies that produce these drugs.