Potential beneficial impacts of tadalafil on CVD

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Abstract

Tadalafil is a selective phosphodiesterase type 5 (PDE5) inhibitor commonly used for the treatment of erectile dysfunction and benign prostatic hyperplasia. Its mechanism of action involves the inhibition of PDE5, leading to increased levels of nitric oxide and cyclic guanosine monophosphate in the corpus cavernosum, which facilitates smooth muscle relaxation. This article reviews studies using tadalafil in the treatment of cardiovascular diseases and emphasizes its potential advantages in conditions such as pulmonary arterial hypertension, atherosclerosis,coronary artery disease, myocardial infarction, heart failure, stroke, diabetic ulcers, and cardiomyopathy. Although tadalafil shows potential efficacy in treating cardiovascular disease,further experimental studies are needed to clarify its pharmacological effects on cardiovascular protection beyond PDE5 inhibition.




2. The effects of tadalafil in cardiovascular disease

2.1. Pulmonary arterial hypertension (PAH)
2.2. Atherosclerosis and CAD
2.3. Heart failure and myocardial infarction
2.4. Stroke
2.5. Diabetic vascular disease
2.6. Cardiomyopathy





3. Potential mechanisms of tadalafil in different cardiovascular diseases
 

Attachments

In conclusion, in this review, in addition to treating ED and BPH, it was highlighted how tadalafil may exhibit significant potential to improve cardiovascular diseases (Table 1).In PAH, tadalafil has been shown to reduce pulmonary arterial pressure, improve exercise capacity, and reduce clinical deterioration. In atherosclerosis and CAD, tadalafil may help attenuate the progression of atherosclerosis and CAD. In heart failure and myocardial infarction, tadalafil has demonstrated cardioprotective effects by reducing cardiac hypertrophy,pulmonary edema, and myocardial infarct size. In stroke and diabetic vascular disease, tadalafil has led to improvements in microvascular perfusion, which may benefit patients with ischemic stroke and diabetic wounds. In cardiomyopathy, tadalafil has demonstrated potential in alleviating chemotherapy-induced cardiomyopathy and delaying muscular dystrophy-related cardiomyopathy in animal models. Although tadalafil has received approval from the FDA asa commercial medication for the treatment of ED, BPH, and PAH, it might be used cautiously in subjects at high risk of cerebrovascular ischemic events. While tadalafil demonstrates potent efficacy in various cardiovascular diseases, its appropriate dosage and potential. applications indifferent medical conditions continue to generate significant interest. Given the potentially wide application of tadalafil to clinical settings, its novel pharmacological effects on cardiovascular protection beyond PDE5 inhibition also require further experimental investigation.
 
Good to see a discussion of a very potent promoter of CV health with no mention of cholesterol. Nitric Oxide is a big deal. Also, as Dr Kendrick discusses in his book on heart health (The Clot Thickens), statins (weakly) promote Nitric oxide, so their barely detectable benefit may be due to that and not cholesterol lowering.
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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