Benefits of Tadalafil and Sildenafil on Mortality, Cardiovascular Disease, and Dementia.

Autor:	Jehle DVK; Department of Emergency Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: dijehle@utmb.edu., Sunesra R; Department of Emergency Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: rasunesr@utmb.edu., Uddin H; Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: hauddin@utmb.edu., Paul KK; Department of Emergency Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: kkpaul@utmb.edu., Joglar AA; Department of Emergency Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: aajoglar@utmb.edu., Michler OD; Department of Emergency Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: odmichle@utmb.edu., Blackwell TA; Department of Emergency Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US; Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: tblackwe@utmb.edu., Gaalema D; Division of Cardiology, Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: digaalem@utmb.edu., Hayek S; Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: sahayek@utmb.edu., Jneid H; Division of Cardiology, Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, US. Electronic address: hajneid@utmb.edu.
Jazyk:	angličtina
Zdroj:	The American journal of medicine [Am J Med] 2024 Nov 10. Date of Electronic Publication: 2024 Nov 10.
DOI:	10.1016/j.amjmed.2024.10.039
Abstrakt:	Background: Erectile dysfunction and lower urinary tract symptoms, from benign prostatic hyperplasia and bladder neck obstructions, are prevalent in men and associated with an increased risk of cardiovascular diseases. Phosphodiesterase-5 (PDE-5) inhibitors, such as tadalafil and sildenafil, are used to treat erectile dysfunction and may also offer cardiovascular benefits due to their vasodilatory effects. This study evaluates the impact of these PDE-5 inhibitors on all-cause mortality, cardiovascular disease, and dementia in middle-aged men with erectile dysfunction and lower urinary tract symptoms over a 3 year follow-up period. Methods: This longitudinal study analyzed data from 50 million US men using the TriNetX database. Men at least 40 years of age prescribed tadalafil or sildenafil after an erectile dysfunction diagnosis, or tadalafil after lower urinary tract symptom diagnoses, from 2004 to 2021 were included. Three-year outcomes assessed included all-cause mortality, cardiovascular disease, and dementia, comparing men on PDE-5 inhibitors to those not on these medications. Propensity matching was performed for demographics and eight pre-existing conditions. Results: The final cohort included 509,788 men with erectile dysfunction and 1,075,908 with lower urinary tract symptoms. Tadalafil and sildenafil were associated with significantly reduced risks of all-cause mortality (RR 0.66/0.76), myocardial infarction (0.73/0.83), stroke (0.66/0.78), venous thromboembolism (0.79/0.80), and dementia (0.68/0.75) in erectile dysfunction patients, with tadalafil showing more significant benefits. In lower urinary tract symptom patients, tadalafil was similarly associated with reduced mortality, cardiovascular disease, and dementia. Conclusions: In conclusion, tadalafil and sildenafil use in erectile dysfunction patients reduced mortality, cardiovascular disease, and dementia risks, with tadalafil providing more benefits. Tadalafil also conferred similar benefits to patients with lower urinary tract symptoms. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu