Phosphodiesterase Type 5 Inhibitors (PDE5Is) and Their Role in Cardiovascular Health

Bang-Ping JiannTaiwan Speaker Phosphodiesterase Type 5 Inhibitors (PDE5Is) and Their Role in Cardiovascular Health Phosphodiesterase type 5 inhibitors (PDE5Is) recommended as the first line treatment for erectile dysfunction (ED) in men. The increasing experience from PDE5Is use in ED along with a deeper understanding of cGMP-regulated mechanisms, gradually stimulated the scientific interest for further potential applications. PDE5Is were found to ameliorate pulmonary vascular resistance by augmenting NO-mediated vasodilation in the lungs. In animal models, PDE5Is were found to attenuate ischemia-reperfusion myocardial injury and reduce arrhythmia burden. In human studies, PDE5Is substantially improve myocardial contractility and clinical variables in patients with systolic heart failure. Meanwhile, PDE5Is have been shown to reduce pro-inflammatory mediators and improve markers of vascular aging in patients with ED. The pooled analysis of 16 studies demonstrated that the risk of major adverse cardiovscular events and all-cause mortality was reduced by 22% and 30%, respectively, in patients exposed to PDE5Is compared to controls. The use of PDE5Is provides important clinical benefits that extend beyond ED and include cardioprotective effects and improved survival after acute myocardial infarction.