Diabetes is a known risk factor for poor cardiovascular health; studies have suggested people with the condition are almost 50 percent more likely to have a heart attack than those without diabetes. But for men with type 2 diabetes, a new study finds that the erectile dysfunction drug Viagra may lower the risk of heart attack, as well as increase the likelihood of surviving one.
Study co-author Prof. Andrew Trafford, from the Institute of Cardiovascular Sciences at the University of Manchester in the United Kingdom, and colleagues publish their findings in the journal Heart.
Type 2 diabetes is the most common form of diabetes, accounting for around 90-95 percent of all cases.
In type 2 diabetes, the pancreas is either unable to produce enough insulin – the hormone that regulates blood glucose levels – or the body is unable to effectively use the insulin that is produced. As a result, blood glucose levels become too high.
High blood glucose levels can damage the nerves and blood vessels, and high blood pressure, high cholesterol, obesity, and low physical activity are common in people with diabetes – all of which are factors that contribute to heart attack, stroke, and other cardiovascular diseases.
According to the American Heart Association, adults with diabetes are two to four times more likely to die from heart disease than those without diabetes, and around 68 percent of people aged 65 and older who have diabetes die from a form of heart disease.
Prof. Trafford and colleagues note that previous studies have suggested medications called PDE5 inhibitors – which include the drug Viagra (sildenafil), the first-line therapy for erectile dysfunction – may have heart health benefits for patients with diabetes.
- Each year, around 735,000 people in the U.S. have a heart attack
- Of these, 525,000 are a first heart attack
- 1 in 5 heart attacks are “silent,” meaning the heart is damaged without a person being aware.
For this latest study, the team set out to assess how PDE5 inhibitors affect the risk of heart attack incidence and mortality among men with both erectile dysfunction and type 2 diabetes.
The researchers analyzed the 2007-2015 electronic health records of 5,956 men aged 40-89 who had been diagnosed with type 2 diabetes. Of these men, 1,359 were prescribed PDE5 inhibitors for erectile dysfunction.
Overall, the team found that men who were using PDE5 inhibitors were at 31 percent lower risk of all-cause mortality during the average 6.9 years of follow-up.
Among the 1,031 men with a history of heart attack, those treated with PDE5 inhibitors had a 40 percent lower risk of death, compared with those who were not treated with the medication.
Men with history of congestive heart failure, transient ischemic attack – or “mini heart attack” – and peripheral vascular disease (PVD) had a 36 percent, 40 percent, and 34 percent lower risk of death, respectively, with the use of PDE5 inhibitors.
Additionally, the researchers found that men who were taking PDE5 inhibitors were at lower risk of heart attack than those who were not using the medication, with a heart attack incidence of 5.2 percent and 8.9 percent, respectively.
Among the 432 men who did have a heart attack during follow-up, the death rate stood at 25 percent for those who used PDE5 inhibitors, compared with 42.7 percent for those who did not use the drugs.
Prof. Trafford and colleagues say their findings support previous research hailing the heart health benefits of Viagra, and they call for “urgent investigation” into how PDE5 inhibitors might benefit patients with type 2 diabetes.
“[…] there could be considerable clinical benefit beyond the treatment of [erectile dysfunction],” they add.
“Our laboratory work was pointing us towards the potential benefits of these erectile dysfunction treatments on the heart so it’s reassuring to learn that they could reduce heart attack risk and improve heart attack survival in people with diabetes,” says Prof. Trafford.
“Having diabetes is a major risk factor for heart disease so any treatments that could reduce that risk are urgently needed. Erectile dysfunction treatments like Viagra are already licensed for use so, if clinical trials provide further evidence of a life-saving benefit, it might be possible to start treating people with this drug in the not too distant future.”
Prof. Andrew Trafford