title: Cardiovascular outcomes among sildenafil users: results of the International Men's Health Study.
abstract: OBJECTIVE
  To assess the incidence of serious cardiovascular disease (CVD) events [i.e. myocardial infarction (MI) and stroke] and all-cause mortality in men with erectile dysfunction (ED) who received prescriptions for sildenafil.
  
  
  METHODS
  The International Men's Health Study (IMHS) was a prospective, observational cohort study of patients with ED and a new or existing prescription for sildenafil. Baseline and follow-up questionnaires provided information on demographics, CVD risk factors and ED. Postevent questionnaires were mailed to patients following possible nonfatal CVD events to collect information related to exposure to sildenafil/ED treatments before the event.
  
  
  RESULTS
  Thirty-five CVD events were reported in 30 patients in the analysis set (n = 3813). The incidence of all-cause mortality, MI and stroke was 0.4, 0.6 and 0.1 per 100 patient-years of observation respectively. Among the six men who reported using sildenafil in the month before a nonfatal CVD event, two reported use in the 24 h before the event.
  
  
  CONCLUSIONS
  The results of the IMHS support previous reports that ED and CVD are often comorbid and share risk factors.
authors.affiliation: Cardiovascular Epidemiology Research Unit, Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Mittleman
authors.forename: M
authors.initials: M
authors.lastname: Maclure
authors.forename: M A
authors.initials: MA
authors.lastname: Lewis
authors.forename: G C
authors.initials: GC
authors.lastname: Hall
authors.forename: N
authors.initials: N
authors.lastname: Moore
authors.forename: F
authors.initials: F
authors.lastname: Giuliano
authors.forename: H
authors.initials: H
authors.lastname: Porst
authors.forename: H
authors.initials: H
authors.lastname: Hedelin
authors.forename: A
authors.initials: A
authors.lastname: Martin-Morales
authors.forename: R E
authors.initials: RE
authors.lastname: Sobel
authors.forename: R
authors.initials: R
authors.lastname: Reynolds
authors.forename: D B
authors.initials: DB
authors.lastname: Glasser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000150:complications / Q000401:mortality; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D011446:Prospective Studies; D011687:Purines / Q000009:adverse effects; D012307:Risk Factors; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000009:adverse effects*
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate