Vascular effects of sildenafil in hypertensive cardiac transplant recipients.
BACKGROUND
Sildenafil is commonly used in the treatment of erectile dysfunction in hypertensive male cardiac transplant recipients (CTR); however, little is known about the vascular effects of sildenafil in these patients.


METHODS
Central and peripheral arterial blood pressure (BP), heart rate, and brachial artery reactivity were determined in 15 hypertensive male CTR before and after oral sildenafil (50 mg) administration.


RESULTS
Sildenafil improved brachial and aortic systolic BP, pulse pressure, aortic augmentation index, left ventricular tension time index, travel time of the reflected aortic pressure wave, and brachial artery reactivity (P <.01 for each comparison). No patient became hypotensive with sildenafil despite continuation of usual antihypertensive medications.


CONCLUSIONS
Sildenafil (50 mg) is well tolerated in hypertensive CTR and improves BP, aortic augmentation index, and endothelial function. By decreasing the amplitude of the reflected pressure wave and delaying its return to the heart, sildenafil reduces left ventricular afterload and systolic stress.
Schofield
Richard S
RS
Division of Cardiovascular Medicine and Shands Transplant Center, University of Florida College of Medicine, Gainesville, Florida 32610, USA. schofrs@medicine.ufl.edu
Edwards
David G
DG
Schuler
Brian T
BT
Estrada
Juan
J
Aranda
Juan M
JM
Pauly
Daniel F
DF
Hill
James A
JA
Aggarwal
Rahul
R
Nichols
Wilmer W
WW
D000368:Aged; D001011:Aorta / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects*; D001916:Brachial Artery / Q000502:physiology; D007172:Erectile Dysfunction / Q000150:complications / Q000188:drug therapy*; D016027:Heart Transplantation; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D014665:Vasodilator Agents / Q000008:administration & dosage*; D016277:Ventricular Function, Left / Q000187:drug effects
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate