Elsevier

Urology

Volume 59, Issue 5, May 2002, Pages 747-752
Urology

Adult urology
Effects of sildenafil citrate (viagra) on blood pressure in normotensive and hypertensive men

https://doi.org/10.1016/S0090-4295(02)01510-8Get rights and content

Abstract

Objectives. To determine the occurrence of clinically significant decreases in blood pressure (BP) with sildenafil use in normotensive and hypertensive men by means of ambulatory BP monitoring.

Methods. On 2 nights, 49 men (22 hypertensive, 27 normotensive) had their ambulatory systolic BP (SBP), diastolic BP (DBP), and heart rate monitored during the first 3 hours (waking period) and every 30 minutes after midnight for 3 additional hours (sleeping period). No medication was taken on one night; sildenafil 100 mg was taken on the other.

Results. Sildenafil decreased SBP (−6.0 mm Hg; P = 0.0003), DBP (−4.5 mm Hg; P = 0.001), and mean arterial pressure (−5.3 mm Hg; P = 0.00008). The BP-lowering effects of sildenafil did not differ significantly in the normotensive and hypertensive men. Age significantly affected the BP reductions; decreases in SBP, DBP, and mean arterial pressure were greater in men 49 years old and older than in those younger than 49 years old. According to readings averaged over the entire control and treatment periods, 22.7% of hypertensive men and 3.7% of normotensive men experienced SBP reductions of 20 mm Hg or greater (P = 0.08 for comparison of the two groups); the respective values for DBP were 9.1% and 3.7% (P not significant). These reductions were not associated with any hypotensive symptoms. All participants tolerated sildenafil well.

Conclusions. Sildenafil caused small, clinically insignificant reductions in ambulatory BP in active and resting normotensive and hypertensive men. The results of this study suggest that, when used in accordance with the prescribing information and current treatment guidelines, sildenafil should be safe in younger and older men with or without hypertension.

Section snippets

Material and methods

A SpaceLabs ambulatory BP monitor was used to record the systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR). All data were recorded for later analysis.

The 49 men enrolled (22 hypertensive, 27 normotensive) were evaluated for 6 hours on 2 nights. On both nights, participants went to sleep at midnight and did not engage in sexual activity. No medication was taken on the first night; sildenafil 100 mg orally was taken at 9:00 pm on the other. The system was

Sample

The mean age of the 22 hypertensive men was 58.0 years, and the mean duration of hypertension was 7 years; normotensive men had a mean age of 42.3 years. The men with hypertension were treated with antihypertensive medications, including alpha-blockers (n = 10), calcium-channel antagonists (n = 8), and angiotensin-converting enzyme inhibitors (n = 7). Twelve of these men were taking only one drug; 10 were taking two or more medications. One of the hypertensive group also had angina. Preliminary

Comment

The results of our ambulatory monitoring indicate that a single oral 100-mg dose of sildenafil produces modest reductions in BP in both hypertensive and normotensive men, with no significant differences in the drug’s BP-lowering effects between these groups. BP was lowered to a statistically (but not clinically) significantly greater degree (P <0.05) in older men than in younger men, perhaps reflecting the higher baseline values in the older men. Note that the overall greater average age of the

Conclusions

Sildenafil causes small BP reductions in both normotensive and hypertensive men evaluated with ambulatory monitoring while active and at rest. This approach, which more closely approximates the actual clinical use of the drug than office measurements, confirms previous demonstrations of the safety of sildenafil. Overall, sildenafil’s effects in hypertensive men were not significantly greater than those in normotensive men. Concomitant use of one or more antihypertensive medications was not

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