Limited hypotensive effect of sildenafil in a high-risk population: A preliminary report

M. M. Ciulla, P. Nicolini, C. Benfenati, C. Vecchiato, G. Acquistapace, G. L. Perrucci, F. Magrini

Research output: Contribution to journalArticlepeer-review


Erectile dysfunction (ED) is often associated with cardiovascular disease (CVD) and the risk of sildenafilinduced orthostatic hypotension (OH) in subjects with CVD is a matter of concern. We describe our experience in using the tilt test (TT) with continuous plethysmography to evaluate the occurrence of OH in patients with CVD and ED after a test dose of sildenafil. When sildenafil was added on top of their usual pharmacological treatment two patients out of 32 (6.2%) developed asymptomatic OH, with a maximum blood pressure fall of 40/20 mm Hg. The low prevalence and modest clinical relevance of OH in our high-risk population coupled with the known high sensitivity and reproducibility of the TT seem to suggest that sildenafil is haemodynamically safer than is generally believed even when added on top of vasoactive treatment. These findings should be put into perspective against the growing wealth of evidence that PDE5 inhibitors may have therapeutic potential for a number of CV conditions.

Original languageEnglish
Pages (from-to)219-223
Number of pages5
JournalCurrent Drug Safety
Issue number4
Publication statusPublished - Sep 2011


  • Cardiovascular disease
  • Drug safety
  • Erectile disfunction
  • Orthostatic hypotension
  • Sildenafil

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Toxicology
  • Pharmacology


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