Can Viagra Cause a Heart Attack?

Viagra^® is widely considered safe when used properly. In fact, tens of millions of men all over the world use it to treat the symptoms of erectile dysfunction (ED) every year. While you may have heard stories that ED meds can make existing heart disease worse or even cause heart attacks, we’re here to tell you that they’re (mostly) incorrect.

Erectile dysfunction medication has a direct impact on your cardiovascular system. Drugs like Viagra cause vasodilation, meaning they work by relaxing smooth muscles in arteries. Doing so doesn’t normally trigger a heart attack or other heart health problems. But, if taken incorrectly or in combination with certain other drugs, it could cause blood pressure issues and increase your risk and severity of certain side effects.

Below, we’ve delved into the subject of Viagra and its effect on your heart in more detail, because as you’ve probably already realized, this is a complex topic.

During postmarketing surveillance (which takes place after a drug has been FDA approved), heart attacks that have a temporal association with the use of Viagra have been seen in some people. However, it isn’t possible to determine if heart attacks are actually due to Viagra or due to something else (like sexual activity), and it also isn’t possible to know how common this is. That said, if you take certain medications that aren’t meant to be combined with Viagra, it could pose heart-related health risks.

A heart attack, also known as a myocardial infarction, occurs when blood flow to part of the heart muscle is reduced or 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. The arteries supplying blood to the heart become narrowed or closed off, reducing blood flow to the heart. 

You’re probably asking “Is Viagra a vasodilator” expecting us to say that if it is, Viagra should probably prevent heart disease, right?

Viagra — and its main ingredient, sildenafil citrate — can lower blood pressure. If used in combination with certain other medications that lower blood pressure, it’s possible to get dangerously low blood pressure. This could, in theory, result in less blood flow to the heart.

This isn’t the only potential link between ED medication use and heart health: guys taking medications like Levita^®, Cialis^® or Viagra tend to return to vigorous activity. 

Experts cite the results of a 2002 study published in the journal, JAMA, to support the theory that heart attacks linked to Viagra were potentially related to the performance of sexual activity (specifically in patients with coronary artery disease) than to the use of the drug.

The Link Between Heart Disease and ED

Speaking of heart disease and sexual activity, it’s important to note that there is a link between erectile dysfunction and heart disease. 

Erectile dysfunction can sometimes serve as a warning sign for men with underlying heart conditions.

This is because both erectile dysfunction and many cardiovascular issues (heart attack, chest pain or angina, strokes, and other conditions) can be caused by the same issue — atherosclerosis. 

Like we said before, atherosclerosis happens when arteries narrow due to fat and cholesterol buildup, causing the arteries to fail at serving as a vessel for blood flow. If blood can’t sufficiently reach the heart —or the penis — you can run into health episodes. 

If you’re experiencing erectile dysfunction, there could also be underlying heart issues to talk to your healthcare provider about.

Because erectile dysfunction and heart conditions are linked, it’s important to consider the link between erectile dysfunction treatment and heart conditions. The concern is the drug’s effect on the arteries.

Whether Viagra is safe for men with heart disease depends on the individual. For many men with heart disease, a drop in blood pressure of up to 8.3/5.3 mmHg wouldn’t be considered dangerous. 

For certain heart conditions, however, it could be. This may be the case for severe heart failure, aortic stenosis and more.

Like other prescription medications, there is a risk of side effects from Viagra. These are generally mild and temporary, though interactions with other prescription medications can be serious.

For instance, because Viagra was originally developed as a treatment for pulmonary hypertension, it may interact poorly with other heart medications. 

Men taking nitrates and guanylate cyclase stimulators should not take Viagra.

Nitrates are typically prescribed for angina (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. 

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

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, too.

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 Viagra (sildenafil) warnings, check out our blog.

You might also want to read our guide to the most common ED treatments before seeking medical advice from your healthcare provider so you understand the options.