NEW YORK (Reuters Health) - Erectile dysfunction, which is common among patients with congestive heart failure (CHF), is treatable with sildenafil (Viagra) and also improves exercise capacity in these patients, according to the results of a randomized trial.

Men with CHF, along with their wives, are often afraid they will develop symptoms of heart failure or die during sexual activity, lead researcher Dr. Edimar Alcides Bocchi commented a press statement.

"Our study shows that the benefits may outweigh the harmful side effects of treatment with sildenafil. The successful treatment of erectile dysfunction in CHF could not only improve sexual relationships but overall quality and success of CHF treatment," he added.

Dr. Bocchi and colleagues from the São Paulo University Medical School, Brazil, studied 23 CHF male patients with an average age of 50 years. Most patients had moderate or severe heart failure. In the first phase of the randomized, crossover trial, exercise and neurohormonal activation were evaluated after the patients received 50 mg of sildenafil

In this phase, patients underwent a 6-minute treadmill walk test, which was followed by a maximal cardiopulmonary exercise test, according to the report in the August 27th rapid access issue of Circulation: Journal of the American Heart Association.

In the second phase of the study, patients received sildenafil as needed for erectile dysfunction.

Overall, the men who received "sildenafil had significantly lower blood pressure and heart rate and improvement in measures of oxygen consumption and carbon dioxide production compared with those on placebo," the investigators found.

Sildenafil also improved most scores on the International Index of Erectile Function, the Brazilian team noted.

Dr. Bocchi and colleagues speculated that "the reduction in heart rate could decrease the myocardial oxygen consumption during exercise with intensity similar to sexual activity that could be important for ischemic cardiomyopathy."

They added that "sildenafil can become an important tool to resolve the challenge of concomitant improvement in relevant aspects of quality of life without changes in multiregimen drugs necessary to improve prognosis in CHF."

Circulation. 2002 Aug 27;106(9):1097-103

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