In late 2017, the Argentine national soccer team tried Viagra before playing in La Paz, Bolivia. They lost, but Viagra has been used to successfully treat altitude sickness in climbers.
La Paz, the seat of the executive and legislative branches of Bolivia’s government, sits at a dizzying elevation of 11,942 feet — roughly two and a quarter miles above sea level.
For tourists, adjusting to the thinner air — oxygen levels are one-third those found at sea level — at this elevation is a challenge, and they are cautioned to take it easy until they become acclimated to high altitude.
Denied the luxury of gradual adjustment to the thin air of the Andean foothills, athletes from lower climes look for an extra edge, particularly in games against local players who are already accustomed to playing at higher elevations.
Argentine Team Tries Viagra
Heading into a World Cup-qualifying game in La Paz in late March 2017, players on Argentina’s national team tried to gain that extra edge by taking a cocktail of three drugs including Viagra, acetaminophen, and caffeine. Some studies have shown that sildenafil — the active ingredient in Viagra — improves athletic performance at extremely high altitudes.
In the end, the Bolivian national team beat the Argentine team, also known as the Albicelestes, 2 to 0. Whether it was the drug supplement that failed to deliver or the absence of star player Lionel Messi serving a four-game suspension, or a combination of the two, the blame for the less than stellar performance is unclear.
Can Sildenafil Help?
However, the revelation that the Argentinian players were given Viagra to help them cope with the physiological stress of high-altitude play once again puts the spotlight on the ability of sildenafil to improve athletic performance at higher elevations.
One of the landmark studies on this topic was published in the June 2006 issue of the “Journal of Applied Physiology.” The research team, most of whom were associated with Stanford University and the Veterans Affairs Palo Alto Health Care System, looked specifically at sildenafil’s effects on athletic performance at elevations higher than La Paz’s 11,942 feet.
Specifically, researchers involved in the 2006 study compared sildenafil’s effects on athletic performance and cardiac output at both sea level and at an elevation of roughly 12,710 feet, almost 800 feet higher than the stadium in La Paz.
Sildenafil Also Treats PAH
Viagra (sildenafil) is best known for its ability to temporarily overcome symptoms of erectile dysfunction by increasing blood flow to the penis. The drug, under the brand name Revatio, is also prescribed for the treatment of pulmonary arterial hypertension, or PAH, a condition in which high blood pressure targets the arteries carrying blood between the heart and lungs.
Researchers theorized that the drug might also help trained athletes to overcome the symptoms of temporary pulmonary hypertension experienced at extremely high elevations. They also felt that the drug’s vasodilating properties would help increase the delivery of much-needed oxygen to muscle tissues that might otherwise be starved for oxygen and thus less efficient. Researchers also believed that sildenafil supplementation would do little, if anything, to improve athletic performance at normal elevations.
Trained Cyclists Put to the Test
To test its theories, the research team recruited 10 trained cyclists to participate in its study. The athletes were then put through their paces, including a total of 10 cycling trials at both sea level and at a simulated high altitude of 12,710 feet. During this series of trials, athletes were randomly selected to receive varying doses of sildenafil or a placebo but were not told what drugs they were being given. For trials at simulated high altitude, participants began breathing hypoxic gas (12.8 percent oxygen) one hour before the cycling test began.
Study participants given sildenafil for sea-level cycling trials showed no improved performance over those who received placebo. However, those given sildenafil, regardless of dose, for simulated high altitude trials exhibited increased cycling stroke volume, cardiac output, and arterial oxygen saturation. The researchers concluded that sildenafil could help improve athletic performance for some athletes at higher elevations — 12,710 feet or higher.
A Different Conclusion
Another research study, conducted by scientists from Spain’s University of Barcelona, reached a different conclusion about the effects of sildenafil on athletic performance at higher elevations. That study was published in a 2016 issue of the “International Journal of Sports Medicine.”
Eleven volunteers were subjected to exercise tests at both sea level and at a simulated elevation of about 13,125 feet. One hour before the tests at simulated higher elevation, test participants were given a 100-milligram tablet of sildenafil. However, they were not given an opportunity to acclimatize to the hypoxic conditions prior to the beginning of such tests, as was done in the Stanford study. Authors of the Spanish study concluded that “the use of sildenafil to improve physical performance in non-acclimatized subjects is not supported by our data.”
It should be noted that both of the studies cited here were very small in scale — 10 subjects in one and 11 subjects in the other. In view of the disparate findings, additional studies, preferably with a larger number of study participants, should be undertaken to more accurately determine what, if any, benefit supplementation with sildenafil confers on athletic performance at extremely high elevations.
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