Erectile dysfunction (ED) medications appear to include a bonus benefit: a healthier heart. Multiple studies have indicated that PDE5 inhibitors, a class of drugs that includes well-known brands Viagra®, Cialis®, and Stendra®, may reduce a patient’s risk of experiencing major adverse cardiovascular events (MACE) like heart attacks or strokes.
Experts are building on this research with a first-of-its-kind study focused on tadalafil (also sold under the brand name Cialis), a long-acting PDE5 inhibitor that can be taken daily or as needed to treat ED. In addition to providing further evidence that ED medications can boost heart health, the study published in Clinical Cardiology also points to a link between dosage levels and patient outcomes.
How Longer Exposure to a PDE5 Inhibitor May Improve Patient Outcomes
The purpose of the observational study was to analyze whether prolonged exposure to a PDE5 inhibitor leads to improved cardiovascular outcomes. Tadalafil is unique as an ED drug because it’s a long-acting agent that remains in the system for up to 36 hours, which is far longer than comparable medications like Viagra (learn more about the differences between Cialis and Viagra here). Tadalafil is also FDA-approved for daily use.
Researchers retrospectively analyzed data from a large U.S. commercial insurance claims database and compared the information to the national death index. They identified adult men diagnosed with erectile dysfunction between January 2006 and October 2020.
The researchers divided the men into two groups: The first included more than 8,000 men who started using tadalafil after receiving their diagnosis and had not experienced MACE in the 12 months before beginning the drug. The second group comprised more than 21,000 men diagnosed with ED who did not take tadalafil or any other PDE5 inhibitor.
The analysis revealed the men who took tadalafil fared better than the ones without exposure to the drug. Compared to the men who didn’t take any PDE5 inhibitors, the men exposed to tadalafil had:
19% lower adjusted rates of MACE, including significantly lower rates of coronary revascularization and unstable angina
44% lower mortality rates
Dosage levels also contributed to patient outcomes. The men who took tadalafil were subdivided based on the number of tablets prescribed during the analysis period. The data revealed that higher dosages correlated with lower MACE and mortality rates.