title: Vascular effects of sildenafil in hypertensive cardiac transplant recipients.
abstract: 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.
authors.affiliation: Division of Cardiovascular Medicine and Shands Transplant Center, University of Florida College of Medicine, Gainesville, Florida 32610, USA. schofrs@medicine.ufl.edu
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schofield
authors.forename: David G
authors.initials: DG
authors.lastname: Edwards
authors.forename: Brian T
authors.initials: BT
authors.lastname: Schuler
authors.forename: Juan
authors.initials: J
authors.lastname: Estrada
authors.forename: Juan M
authors.initials: JM
authors.lastname: Aranda
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Pauly
authors.forename: James A
authors.initials: JA
authors.lastname: Hill
authors.forename: Rahul
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Wilmer W
authors.initials: WW
authors.lastname: Nichols
mesh_terms: 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
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate