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By the 1990s in early trials of the drug, researchers noticed an interesting side effect — an increase in erections.

In 1996, the pharmaceutical company Pfizer patented it as Viagra, and in just two years, doctors had ordered more than 40,000 prescriptions of the new wonder drug.

“When the

drug

first came out there was a big scare — is this going to kill people?” said Dr. Kociol, director of the heart failure program at the CardioVascular Institute at Beth Israel Deaconess Medical Center in Boston.

“But in all studies, to the best of my knowledge, it’s not shown any increase in cardiac events in patients who take these drugs,” he said. Past studies have suggested Viagra and other PDE5 inhibitors may have benefits for heart failure by decreasing pulmonary artery resistance and providing cardio-protective effects in settings with

low

blood flow, according to Kociol. “They also improve exercise tolerance in patients with heart failure,” he said.

The drug may even reduce the size of a heart attack.

But Kociol said scientists have to “temper” their enthusiasm as more studies are necessary.

“As interesting as this paper is, there have been conflicting results,” he said. “If there is a silver bullet, it remains to be seen.” Kociol added that researchers also need to “pay more attention” differences between men and women and between racial groups. Some earlier research suggests that drugs like Viagra might interact differently with estrogen, which is known to have naturally protective properties for the heart.

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VIAGRA BLUNTS EFFECTS OF STRESS ON THE HUMAN HEART.

Johns Hopkins Medicine Office of Corporate Communications Media contact: David March 410-955-1534; dmarch1@jhmi.edu October 24, 2005. VIAGRA BLUNTS EFFECTS OF STRESS ON THE HUMAN HEART. Sildenafil citrate (Viagra), a drug used to treat erectile dysfunction (ED) in millions of men, reduces the stimulatory effects of hormonal stress on the heart by half, according to results of a new study by researchers at Johns Hopkins. While sildenafil is more widely known for helping genital blood vessels expand to maintain an erection and, more recently, as a treatment for pulmonary hypertension, it has been thought to have little direct effect on the human heart.

In the heart, sildenafil blunts the strengthened heartbeat caused by chemically induced stress, thereby lessening the excess amount of blood and force used to pump it to the body, according to study senior author and cardiologist David Kass, M.D., a professor at The Johns Hopkins University School of Medicine and its Heart Institute. “Sildenafil effectively puts a ‘brake’ on chemical stimulation of the heart,” says Kass. The researchers’ findings, which appear in the journal Circulation online Oct. 24, are believed to be the first confirmation in humans that sildenafil has a direct effect on the heart. Previous research by Kass and his team showed that sildenafil had such effects in mice, blocking the short-term effects of hormonal stress in the heart.

Related studies by the group also showed that sildenafil prevents and reverses the long-term effects in the heart from chronic high blood pressure.

Moreover, Kass adds, the latest Hopkins results confirm that sildenafil helps control heart function only when the heart is under duress, but has little impact under normal conditions.

Separate research from Kass and his team published earlier this year in the journal Nature Medicine showed that, in mice, sildenafil could reverse the negative effects on heart muscle weakened by heart failure and enlargement, a condition called hypertrophy.

“But we had no firm evidence as to whether or how this therapy might work in the human heart. Our latest research provides firm evidence this drug does indeed have an important impact on the heart.” Thirty-five healthy men and women, with an average age of 30 and no previous signs of coronary artery disease, participated in the six-month study. Within a three-hour timeframe, each participant received two separate injections of dobutamine (5 micrograms per kilogram for five minutes), a synthetic, adrenaline-like chemical that increases heart rate and pumping strength.

Between injections, study participants were randomly assigned to a group that was treated with sildenafil (100 milligrams taken orally) or to a group given a sugar pill placebo. All participants were then given the second dobutamine injection to see what effects sildenafil or placebo had on the heart.

Measurements of heart function were made before and after each injection. This included blood pressure readings, electrocardiograms and echocardiograms, as well as blood samples to confirm relatively equal levels of sildenafil and other enzymes.

Results showed that each dobutamine injection stimulated heart function, increasing heart rate and the force of each heartbeat used to pump blood throughout the body.

“This stimulation is similar to the way the nervous system normally increases heart function when triggered by emotional or exercise stress, or in diseases such as heart failure,” adds Kass. After the first injection of dobutamine, the force of heart contraction increased by 150 percent in both groups. And in the placebo group, this increase repeated itself after the second injection.

However, in the group treated with sildenafil, the increased heartbeat was slowed by 50 percent, resulting in a smaller increase in blood flow and blood pressure generated by the heart in response to chemical stimulation.

Between injections, heart function was not altered in the sildenafil group, demonstrating the absence of adverse side effects on the resting human heart.

“Knowing more about the viagra online no prior prescription effects of sildenafil on heart function will allow for

safer

evaluation of its use as a treatment for heart problems,” says Kass.

“Until now, it was widely thought that drugs like sildenafil had no effects on the human heart and that its only purpose was vasodilation in the penis and the lungs.

“Our results set the stage for further studies of sildenafil’s immediate and long-term effects on the heart and its ability to modify other neurohormonal and stress stimuli, including adrenaline and hypertension,” he adds.

While the precise biological actions of sildenafil in the heart are not fully understood, the drug is known to work by stopping the action of an enzyme, called phosphodiesterase 5 (PDE5A), the researcher says. This enzyme is involved in the breakdown of a key molecule, cyclic GMP, which helps control stresses and limit overgrowth in the heart.

PDE5A is also the biological pathway blocked in the penis by sildenafil to

promote

the relaxation of blood vessels and maintain erections.

Funding for this study was provided by the National Institutes of Health (NIH), the Peter Belfer Laboratory Foundation and the Bernard Family Foundation.

The makers of the drug had no involvement in the design or support of the research. These are external links and will open in a new window.

These are external links and will open in a new window. Amid the fall-out from US President Donald Trump's announcement on Twitter that transgender people will not be able to serve in the US military, one statistic has been frequently raised to draw attention to the comparatively small estimated costs of transgender healthcare.

It refers to the amount the Pentagon spends on erectile dysfunction medication annually: about $84m (?63m), according to the Military Times newspaper. In contrast, the Rand Corporation think tank estimated last year that gender transition-related health care costs for transgender personnel would increase the military's active duty health budget by $8.4m per year at the most.

But why does the US defence department spend so much on erectile dysfunction drugs? First, it is worth pointing out that the Military Times' February 2015 report based its figure on 2014 data from the Defense Health Agency.

The spend of $84.2m was for that year, but the newspaper also reported that $294m had been spent on Viagra, Cialis and other such medications since 2011.

It pointed out that this cost the equivalent of more than a few fighter jets. In 2014, some 1.18 million prescriptions were filled, mostly for Viagra. The answer goes some way in explaining the massive spend. It is true that some of the erectile dysfunction medication went to active-duty personnel. But the vast majority went to other groups eligible, including millions of military retirees and their family members.

In fact, around 10 million people in total are estimated to be covered by the Pentagon's healthcare system, which cost $52bn in 2012. It is order viagra well known that erectile dysfunction is more common among older men - which would explain a hefty bill for retired service members.

In fact, less than 10% of the prescriptions were for active duty personnel, according to the Military Times.

Still, erectile dysfunction among those currently serving in the US military has been increasing since the wars in Iraq and Afghanistan began.

'Psychological causes' A 2014 study by the Armed Forces Health Surveillance Branch (AFHSB) found that 100,248 cases of erectile dysfunction were diagnosed among active service members

between

2004 and 2013, with "annual incidence rates" more than doubling in that time period.

Nearly half of all the cases were due to psychological causes, according to the study.

A study published in the Journal of Sexual Medicine in 2015 found that male veterans with post-traumatic stress disorder (PTSD) were "significantly more likely than their civilian counterparts to report erectile dysfunction or other sexual problems", according to the US Department of Veterans Affairs. One study cited found that 85% of male combat veterans with PTSD report erectile dysfunction, nearly four times the rate among those returning from combat who are not diagnosed with a mental health disorder. In

2008

, the Rand Corporation reported that one in order viagra five US

veterans

of the wars in Iraq and Afghanistan were suffering from PTSD or major depression.

However, a key statistic buried in the AFHSB study of active duty personnel between 2004 and 2013 suggests one should be cautious of reading too much into the links between America's recent wars, PTSD and erectile dysfunction in relation to the military's massive spend on Viagra.

Personnel who had never been deployed were actually more likely to suffer from erectile dysfunction than their counterparts who had been. Finally, erectile dysfunction is linked to common conditions, including heart disease, high blood pressure, and diabetes. In 2007, it was estimated that the prevalence of erectile dysfunction among US men was 18%.

In summary: it is a common condition, and the US military pays for the healthcare of millions of men, meaning it spends a lot on Viagra and other such drugs.

Levitra (vardenafil hydrochloride) and Viagra (sildenafil) are erectile dysfunction drugs that work by blocking a certain enzyme (phosphodiesterase-PDE5) used to treat erectile dysfunction (impotence).

headache, flushing (warmth or redness in your face, neck, or chest), runny or stuffy nose, stomach upset, heartburn, dizziness, back pain, or nausea.

Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088.

Common side effects of Viagra include: warmth or redness in the face, neck, or chest, stuffy nose, headaches, stomach pain, upset stomach, nausea, diarrhea, memory problems, back pain, an

inability

to differentiate between the colors green and blue, loss of hearing, ringing in the ears, and dizziness.

Levitra is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men. ED is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection.

A man who has trouble getting or keeping an erection should see his doctor for help if the condition bothers him. Levitra may help a man with ED get and keep an erection when he is sexually excited.

Viagra is a prescription medicine used to treat erectile dysfunction (ED).

You will not get an erection just by taking this medicine. Viagra helps a man with erectile dysfunction get and keep an erection only when he is sexually excited (stimulated). It is not known if Viagra is safe and effective in women or children under 18 years of age.

Levitra may interact with other medications for erectile dysfunction, conivaptan, imatinib, isoniazid, antidepressants, antibiotics, antifungals, drugs to treat high blood pressure or a prostate disorder, heart or blood pressure medications, or HIV/AIDS medicines.

Viagra may interact with other medications for erectile dysfunction, conivaptan, imatinib, isoniazid, antidepressants, antibiotics, antifungals, drugs to treat high blood pressure or a prostate disorder, heart or viagra tablet low price blood pressure medications, or HIV/AIDS medicines.

Some men can only take a low dose of Levitra because of medical conditions or medicines they take. Your doctor will prescribe the dose that is right for you.

If you are older than 65 or have liver problems, your doctor may start you on a lower dose of Levitra.

If you have prostate problems or high blood pressure, for which you take medicines called alpha-blockers, your doctor may start you on a lower dose of Levitra.

If you are taking certain other medicines your doctor may prescribe a lower starting dose and limit you to one dose of Levitra in a 72-hour (3 days) period. Take 1 Levitra tablet about 1 hour (60 minutes) before sexual activity.

Some form of sexual stimulation is needed for an erection to happen with Levitra.

Do not change your dose of Levitra without talking to your doctor.

Your doctor may lower your dose or raise your dose, depending on how your body reacts to Levitra. Call your doctor or emergency room immediately if you accidentally took more Levitra than prescribed.

Take Viagra exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much Viagra to take and when to take it.

Your healthcare provider may change your dose if needed. You may take Viagra between 30 minutes to 4 hours before sexual activity if needed. If you take Viagra after a high fat meal (such as a cheeseburger and french fries), Viagra may take a little longer to start working Do not take Viagra more than 1 time a day. If you accidentally take too much Viagra, call your doctor or go to the nearest hospital emergency room right away.



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