Study: Viagra, Cialis Users 25% Less Likely To Suffer Early Death, Here Are Caveats

Could this be considered really hard evidence? A study published on January 13 in the Journal of Sexual Medicine found that men who had taken erectile dysfunction (ED) medications like Viagra, Cialis, or Levitra were 25% less likely to have suffered early death. And those taking such phosphodiesterase type 5 inhibitor (PDE-5i) medications were also less likely to have experienced different types of heart problems. But before you assume that these ED medications will leave you with more of a “heart on” situation, let’s take a harder look at this study.

This study was actually an analysis of claims data from 23,816 men who had filled at least one PDE-5i prescription for ED from January 1, 2006, to October 31, 2020, compared with claims data from a control group of 48,682 men who hadn’t filled any such prescriptions. Now, in this case, claims data was not data on men making claims about about their genitals or their sexual prowess. Rather, it was data on insurance claims, which is when you submit a request for your insurance company to pay for something. As a result, such claims data could show what kinds of medical expenses each of these men had, whether it was for prescription medications, hospitalizations, medical procedures, clinic visits, or other things, and thus give some picture as to what health outcomes each person had. These insurance claims data came from the HealthCore Integrated Research Database that included over 50 million people covered by commercial health plans in the United States such as health maintenance organizations, point of service plans, preferred provider organizations, Medicare Advantage and consumer-directed health plans and indemnity plans.

A research team from Huntington Medical Research Institute (HMRI) in Pasedena, California, (Robert A. Kloner, MD, PhD and Julia Bradsher, PhD, MBA), HealthCore Inc. (Eric Stanek, Pharm D, Christopher L. Crowe, MPH, Mukul Singhal, PhD, Rebecca S. Pepe, MPH) and the University of California, San Francisco, CA (Raymond C Rosen, PhD) conducted this study. After identifying these two groups of men—the ones who had prescriptions for the PDE-5is and the control group of ones who didn’t—they used the claims data as well as data from the National Death Index (NDI) to determine what kind of health outcomes the men in these two groups ended up having during the aforementioned time period. The NDI is one index that you don’t to be listed under, as it is the federal database for all recorded deaths in the United States. Using these data sources, the team was able to follow what happened to those in the PDE-5i group for an average of 37 months and those in the control group for an average of 29 months.

So what really stands out about the results from this study? Well, in addition to having a lower death rate, those who had filled at least one prescription for PDE-5is were 13% less likely to have suffered a MACE. Suffering a MACE didn’t mean that they had close encounter with that BDSM toy that you typically keep hidden in the closet. Rather, it meant that they had suffered a major adverse cardiovascular event (MACE). The research team also found that the PDE-5i group had a 17% lower incidence of heart failure, a 15% lower incidence of getting a coronary revascularization procedure, a 22% lower incidence of unstable angina, and a 39% lower incidence of death from cardiovascular causes.

Additionally, compared to the 25% of men who had filled the lowest number of PDE-5i prescriptions for an average of 5.5 tablets per person, the 25% of men who had filled the greatest number of PDE-5i prescriptions for an average of 191.2 tablets per person were 55% less likely to have suffered a MACE and 49% likely to have died during the follow-up period.

Before you get too excited about these results, though, keep in mind that this study was bursting with limitations. Such an observational study simply cannot prove cause-and-effect. It can only show potential associations, since there could have been a number of different reasons why men who happened to be taking PDE-5is may have been less likely to die. For example, when you are taking ED medications, chances are that you’ll soon be having sex. That’s because typically you don’t take ED medications just for the heck of it, just to ace a job interview, or just to stand out from the crowd so to speak. And when you are regularly having sex, there’s a good chance that you are already reasonably healthy. Sex is probably not the first thing that may come to mind when you are experiencing symptoms like chest pain or shortness of breath.

Moreover, the study focused on ED medications paid for by insurance and did not account for ED medications that were paid for out of pocket or obtained via other means such friends gifting them to you or random strangers throwing ED medications at you. Therefore, the study may not have accurately captured who was actually taking such ED medications.

This isn’t to say that the study was a case of erection fraud, though. While your penis may not be connected directly to your heart (physically at least), what affects the blood vessels in your penis could also affect the coronary arteries supplying blood to your heart and the arteries leading from your heart. That’s because PDE-5is act by block phosphodiesterase enzymes in general and not just those enzymes in your penis, hence the name. They aren’t penis phosphodiesterase type 5 inhibitor or PPDE-5is. Phosphodiesterase enzymes are located in the smooth muscles that sit in the walls of a blood vessels throughout the body. Normally, these enzymes break down cAMP and cGMP molecules within those muscles, leading to higher levels of these molecules that in turn result in decreased calcium levels. Lower calcium levels can prompt the smooth muscles to relax and thus the blood vessels to dilate.

So what happens when blood vessels in your body dilate? Well, your penis, if you happen to have one, should have blood vessels. When these blood vessels dilate and fill with blood, that’s when you get that fun-filled thing called an erection. And that folks is how Viagra, Cialis, Levitra, and other such ED medications work.

So how can you take these mechanisms to heart? Prior studies have suggested that PDE-5is could potentially increase the amount of blood that your coronary arteries supply to your heart muscles. They could also reduce the stiffness of your arteries in general so that your heart doesn’t have to work as hard to pump blood throughout your body. PDE-5is could potentially decrease inflammation or prevent your platelets from clumping together.

In fact, doctors have already been using PDE-5is to treat conditions such pulmonary hypertension where there is a need to dilate blood vessels and increase blood flow to areas that are far from the penis. For example, this CBS Philadelphia news segment described how doctors have been giving such medications to children with congenital heart problems:

Such uses do raise the possibility that PDE-5is could play a bigger role in the treatment other heart conditions in the future. But don’t let premature speculation get out of hand just yet.

Again, this recent Journal of Sexual Medicine study alone should not be enough to erect an argument that such medications can prevent heart problems or help you live longer. More studies are needed to determine whether this may actually be the case. So don’t start taking taking Viagra, Cialis, Levitra, or any other phosphodiesterase type 5 inhibitor regularly just because you want to prevent heart problems or live longer. Don’t treat such erectile dysfunction medications like candy. They can come with side effects so to speak. And some of these side effects could stand out more than others.