Can Viagra Cause a Heart Attack?

If you struggle with erectile dysfunction (ED), you’re not alone. In fact, ED is the most common form of sexual dysfunction, affecting as many as one-third of all men.

Though the knowledge that you’re not alone in your struggle may not make you feel better, the knowledge that erectile dysfunction is treatable certainly should. 

There are several FDA-approved ED medications available and, while they may not cure erectile dysfunction, they can help you achieve and maintain an erection firm enough for satisfying sex. 

Viagra®  is the most commonly used ED drug. It comes in several dosages and generally works within 30 minutes after taking it

Like most erectile dysfunction drugs, Viagra is only available by prescription. Though Viagra  is widely considered safe when used properly, you may have heard that ED drugs like this can make existing heart disease worse or even cause heart attack.

Below, we’ve delved into the subject of Viagra and its effect on your heart. We’ll address concerns about Viagra interacting with heart medication and whether it is safe for men with heart disease. Finally, we’ll answer the question of whether Viagra can cause a heart attack.

Viagra: The Basics

  • Viagra is the brand name of the generic drug sildenafil. It was originally developed for the treatment of pulmonary arterial hypertension (PAH) but has also been approved by the FDA for the treatment of erectile dysfunction. 

  • This drug has been on the market since the late 1990s and while brand-name Viagra was once fairly pricey, the generic sildenafil is much more affordable. 

  • Viagra is a PDE5 inhibitor that works by blocking the effects of an enzyme called phosphodiesterase type 5. In doing so, it helps increase blood flow to the penis, which makes it easier for you to get and maintain an erection when sexually aroused. 

  • Both Viagra and generic sildenafil come in dosages ranging from 20mg to 100mg per tablet (Viagra starts at 25mg), it generally takes between 30 and 60 minutes for the medication to be effective and the effects can last for several hours. 

  • Like all medications, Viagra has the potential to cause side effects. These are generally mild and temporary, though interactions with other prescription medications can be serious. The most common side effects of Viagra are headache, flushing, upset stomach, abnormal vision, nasal congestion, muscle pain and dizziness. 

Is There Any Interaction with Heart Medication? 

Like other prescription medications, Viagra comes not only with a risk of side effects, but a risk of interaction with other medications. Because Viagra was originally developed as a treatment for pulmonary hypertension, it may interact poorly with other heart medications. 

The manufacturer suggests men taking nitrates and guanylate cyclase stimulators should not take Viagra. Nitrates are typically prescribed for chest pain and guanylate cyclase stimulators like Adempas® (generic riociguat) are prescribed for pulmonary hypertension. 

Pairing Viagra with these medications may cause your blood pressure to drop to an unsafe level. Similarly, patients who have recently taken Viagra should not be given nitrates. 

Is Viagra Safe for Men with Heart Disease? 

Even for men not taking nitrates, there has been some concern surrounding whether Viagra might make underlying heart conditions worse. 

Generally speaking, ED medications are safe for men with healthy hearts. But men with cardiovascular disease should always exercise an added degree of caution when taking new medications. 

The concern with Viagra and heart conditions is the drug’s effect on the arteries

Though Viagra is intended to work on the arteries in the penis, its effects are systemic. All arteries in the body product nitric oxide, so Viagra could potentially trigger vasodilation in other arteries, which could cause a temporary drop in blood pressure by 5 to 8 mmHg. 

Given the known interactions between Viagra and heart medications, the FDA has urged caution in patients who have experienced heart attack, stroke or other serious cardiovascular events within six months. 

Men with a history of congestive heart failure, low blood pressure or uncontrolled high blood pressure should exercise caution, as well. 

Whether Viagra is safe for men with heart disease depends on the individual. 

For many men with heart disease, a minor drop in blood pressure of up to 8.3 / 5.3 mmHg would not be considered dangerous. For certain heart conditions, however, it could be. 

This may be the case for severe heart failure, aortic stenosis, hypertrophic cardiomyopathy, ischemia, and pulmonary veno-occlusive disease. 

Can Viagra Cause Heart Attack? 

A heart attack, also known as a myocardial infarction, occurs when blood flow to part of the heart muscle is interrupted. Some of the most common symptoms of heart attack include chest pain, weakness, shortness of breath and pain or discomfort in the back, arms or shoulders. 

In most cases, a heart attack is the result of atherosclerosis — the narrowing of the arteries caused by the buildup of fat, cholesterol and other substances. 

In other words, the arteries supplying blood to the heart become closed off, cutting off blood flow to the heart. 

Viagra is a vasodilator, meaning it helps open up blood vessels and arteries. That being said, there have been reports of heart attack, stroke, arrhythmia and even death in men taking Viagra. 

Some experts cite the results of a 2002 study to support the theory that heart attacks linked to Viagra  were more likely related to the performance of sexual activity (specifically in patients with coronary artery disease) than to the use of the drug. 

In this study, sildenafil had no effect on symptoms during exercise in men with stable coronary artery disease. 

There is no conclusive evidence linking Viagra  to heart attack, but men with existing heart conditions and those who are taking heart medications should avoid or exercise caution when taking erectile dysfunction drugs. 

In Conclusion 

Talk to your healthcare provider about the potential risks before taking Viagra. Make sure to tell them about any medication, both prescription and non-prescription, you may be taking, and about any underlying health conditions you have. 

For more information about erectile dysfunction, check out our in-depth guide to symptoms, causes, and treatments. You might also want to read our guide to the most common ED treatments before talking to your healthcare provider so you understand the options. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.