Key takeaways:
Many of the things that lead to heart disease also cause erectile dysfunction (ED). These include smoking, diabetes, high blood pressure, and high cholesterol.
Medications like Viagra (sildenafil) can safely treat ED in most people with heart disease. But people who take nitrate medications shouldn’t use ED medications.
ED is a side effect of many medications that treat heart conditions. Talk to a healthcare professional if you’ve started a new medication and now have ED.
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If you have heart disease, you may also have trouble getting or keeping an erection at some point in time. You’re not alone. In fact, erectile dysfunction (ED) is especially common in men who have heart disease. That’s because many of the risk factors that lead to heart disease also cause ED.
If ED happens regularly, you might feel frustrated or embarrassed. And you may begin to wonder about your treatment options and whether it’s safe to treat ED if you have a heart condition. Let’s take a closer look at how medications that treat ED, like Viagra (sildenafil), affect heart health.
What is erectile dysfunction?
Erectile dysfunction (ED) is a condition where you have trouble getting or keeping an erection long enough to have sex. It affects millions of men around the world. ED can be the result of many different conditions, including heart disease. Treating the underlying issue is critical for helping you stay as healthy as possible.
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What is heart disease?
Heart disease includes a range of conditions related to the heart itself and/or the blood vessels. Common examples are:
Irregular heartbeat (arrhythmia)
Heart disease usually develops over time. In some cases, though, you may be born with it (congenital heart disease). Four of the biggest risk factors for developing heart disease include:
High blood pressure (hypertension)
How are heart disease and ED related?
The heart and blood vessels are very important when it comes to erections. After all, erections happen when the blood vessels in the penis open up and allow for more blood flow. If for some reason that blood flow is interrupted, blocked, or slowed, you might not be able to get or keep an erection. Almost all of the risk factors for heart disease are also risk factors for ED.
Depending on the condition, heart disease can change blood flow in different ways. Blood flow may be affected if the:
Heart isn’t pumping strongly enough (due to heart failure)
Blood vessels are damaged (due to high blood pressure)
Blood vessels are blocked (due to high cholesterol)
Did you know that certain foods and drinks can impact how well Viagra works? These are some things to avoid to make sure you get the best results.
Questions about Viagra? GoodRx has the answers. Here are some FAQs about Viagra along with the answers you’re looking for.
Is erectile dysfunction (ED) permanent? Not necessarily. Here are some curable causes of ED.
Because they’re closely linked, ED can often be one of the first signs that you might have an underlying heart condition. That’s one reason it’s important to talk to a healthcare professional if you’re having erectile symptoms.
Can medications that treat ED affect heart conditions?
Medications that treat ED work by blocking an enzyme in the lining of the blood vessels. They increase the amount of nitric oxide in the bloodstream. This causes the vessels to dilate and allows more blood to flow into the penis. These medications include:
Sildenafil (Viagra)
Avanafil (Stendra)
Tadalafil (Cialis)
Vardenafil (Levitra)
- HydrochlorothiazideGeneric Esidrix and Hydrodiuril and Microzide and Oretic
- FurosemideGeneric Lasix
- AtenololGeneric Tenormin
In the past, there have been concerns about whether these medications are safe to use in people with heart conditions. But experts agree that most people with heart conditions can take ED medications. When used correctly, medications like Viagra are safe and effective. And they can help improve the quality of life of people with ED and heart disease.
The only absolute exception is people who take nitrate medications. If you have heart disease and take medications like isosorbide dinitrate or nitroglycerin, you shouldn’t take medication for ED.
Nitrate medications can interact with ED medications like Viagra and cause an unsafe drop in blood pressure. You’ll need to talk with your prescriber about alternative treatments. It’s also important to talk with a healthcare professional if you have a history of unstable blood pressure or are being treated for coronary artery disease.
Potential risks and benefits of Viagra
Viagra and similar medications have become the cornerstone for treating ED. Like all medications, they can have great benefits but they also may carry some risk. Viagra benefits are that it:
Is safe, reliable, and easy to take
Is a non-surgical approach to ED, with no need for injections or medical devices
Can improve confidence and reduce performance anxiety
Viagra affects blood vessels throughout the body, not just in the penis. As a result, some risks of the medication include:
Side effects like headaches, flushing, upset stomach, and nasal congestion
Severe low blood pressure, especially if also taking alpha blockers or other anti-hypertensives
Priapism (prolonged, painful erection)
Hearing loss, dizziness, or vertigo
Can medications that treat heart disease cause ED as a side effect?
Yes, some medications that treat blood pressure and other heart conditions can cause ED as a side effect. Some types of medications that can contribute to ED include:
Diuretics (like hydrochlorothiazide, spironolactone, and furosemide)
Beta blockers (like atenolol and metoprolol)
Calcium channel blockers (like amlodipine, diltiazem, and verapamil)
Other medications that lower blood pressure (like methyldopa and clonidine)
Medications to help with the pumping action of the heart (like digoxin)
Statins (like atorvastatin and simvastatin)
Fibrates (like fenofibrate and gemfibrozil)
Let a healthcare professional know if you have ED and take medications to keep your heart healthy. They’ll need to figure out if your ED is happening as a side effect of the medication. Or they’ll need to see if your medications aren’t effective in treating your heart disease so that you can keep an erection. You and a healthcare professional may need to work together to change your dose or consider other medications.
Quiz: Is it erectile dysfunction?
Frequently asked questions
No, Viagra isn’t thought to cause heart attacks, according to the American Heart Association. Side effects are usually minor, like headache and dizziness. That said, you should always check with a healthcare professional first, especially if you have severe cardiovascular disease.
Viagra is considered safe for most people. But you shouldn’t take Viagra if you:
Are allergic to any component of the medication.
Are on a nitrate
Have multiple system atrophy or pulmonary hypertension due to sickle cell anemia
Have pulmonary veno-occlusion or left ventricular outflow obstruction
Have Ischemic optic neuropathy or inherited degenerative retinal disorders
A heart blockage doesn’t cause ED directly. But ED and heart blockages can both be a result of buildup in the blood vessels throughout the body. If you’re having ED, a healthcare professional will check to make sure you don’t also have heart vessel blockages.
There have been reports of Cialis and Viagra increasing the risk of developing or rupturing aortic aneurysms. The risk appears to be small, but it’s serious. More research is needed to figure out the link and risk factors for this to occur.
No, Viagra isn’t thought to cause heart attacks, according to the American Heart Association. Side effects are usually minor, like headache and dizziness. That said, you should always check with a healthcare professional first, especially if you have severe cardiovascular disease.
Viagra is considered safe for most people. But you shouldn’t take Viagra if you:
Are allergic to any component of the medication.
Are on a nitrate
Have multiple system atrophy or pulmonary hypertension due to sickle cell anemia
Have pulmonary veno-occlusion or left ventricular outflow obstruction
Have Ischemic optic neuropathy or inherited degenerative retinal disorders
A heart blockage doesn’t cause ED directly. But ED and heart blockages can both be a result of buildup in the blood vessels throughout the body. If you’re having ED, a healthcare professional will check to make sure you don’t also have heart vessel blockages.
There have been reports of Cialis and Viagra increasing the risk of developing or rupturing aortic aneurysms. The risk appears to be small, but it’s serious. More research is needed to figure out the link and risk factors for this to occur.
The bottom line
Heart conditions and ED are closely linked. Risk factors that cause heart disease can also cause ED. And some treatments for heart conditions can make ED worse.
Luckily, there are many medications for ED. And most people with heart conditions can safely take medications like Viagra. But it’s important to follow your healthcare team’s instructions. If you have ED, be sure to talk with them about your symptoms. They can help figure out the best treatment plan for you.
Why trust our experts?
References
Chamsi-Pasha, H. (2001). Sildenafil (Viagra) and the heart. Journal of Family & Community Medicine.
Cheitlin, M. D., et al. (1999). Use of sildenafil (viagra) in patients with cardiovascular disease. Circulation.
Lameijer, C. M., et al. (2012). Type b aortic dissection after the use of tadalafil. The Annals of Thoracic Surgery.
LiverTox. (2017). Phosphodiesterase type 5 (PDE5) inhibitors.
Muller, A. J., et al. (2010). Taking the stress out of treating erectile dysfunction. Canadian Family Physician.
Smith, B. P., et al. (2023). Sildenafil. StatPearls.
Speakman, M. T., et al. (1999). Viagra and cardiovascular disease. Journal of Cardiovascular Pharmacology and Therapeutics.
Terentes-Printzios, D., et al. (2022). Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nature Reviews Cardiology.
Tiryakioglu, S. K., et al. (2009). Aortic dissection due to sildenafil abuse. Interactive CardioVascular and Thoracic Surgery.
