Cialis Helps in Reducing Pulmonary Arterial Hypertension, Study Shows

Tadalafil, the active ingredient in Cialis, has been found to help treat pulmonary arterial hypertension, a form of high blood pressure that targets the arteries that supply the lungs. Sildenafil, Viagra’s active ingredient, is already widely in use as a treatment for PAH.

The drugs used to treat erectile dysfunction have many potential other uses as well. Known collectively as PDE5 inhibitors, these drugs (like Viagra, Cialis, and others)
work by allowing the smooth muscle cells lining blood vessel walls to relax and allow for better blood flow. Since this is a general circulatory issue being addressed, it only makes sense that this class of drugs might find other uses that have absolutely nothing to do with erectile dysfunction.

Indeed, researchers are exploring plenty of health issues completely unrelated to sexual function that may be addressed by drugs in the PDE5 class. In fact, PDE5 inhibitors didn’t start out being studied as a treatment for erectile dysfunction. The drug that would eventually become Viagra started out as a potential treatment for a heart condition called angina. It was only after the “side effect” of stronger erections was consistently reported by male study participants that scientists started exploring it as a possible treatment for erectile dysfunction. Today, however, Viagra and drugs like it are being studied as treatments for a number of conditions.

What Is Pulmonary Arterial Hypertension?

Pulmonary arterial hypertension (PAH) is a condition in which the blood pressure in pulmonary arteries (the ones supplying the lungs) is too high. The pulmonary arteries take blood that is being returned from circulation to the lungs, where it is given fresh oxygen. When pressure in the pulmonary arteries is too high, it causes a strain on the heart. Pulmonary arterial hypertension is relatively rare, but it is a life-threatening condition that worsens over time.

The disease may have unknown causes, may be linked to genetic factors, or may occur alongside other medical conditions. Medical conditions with which PAH is associated include congenital heart and lung diseases, HIV, collagen vascular disease, portal hypertension (which usually results from liver disease), and abuse of certain drugs (like amphetamines).

PAH Has Many Causes

When the small arteries of the lungs become abnormally narrow, PAH can result. Sometimes this happens because the muscles within the arterial walls contract, making blood flow more difficult. Tiny blood clots may form, blocking blood flow, or the arterial walls may thicken because of too much cell growth in their lining. The end result is that the heart has to work extra hard, eventually weakening until it can no longer pump blood efficiently. Symptoms of PAH include shortness of breath, fatigue, dizziness, and fainting.

Pulmonary arterial hypertension is more common in women and more common in people with family history of pulmonary hypertension. In 1997, the weight loss drug combination of fenfluramine and dexfenfluramine was removed from the market after being associated with heart valve damage and an increase in the risk for PAH.

How Might Cialis Help?

Cialis, like other drugs in its class, works by inhibiting the action of an enzyme in the body known as phosphodiesterase-5. By inhibiting the action of PDE5, the drug keeps another compound known as cyclic guanosine monophosphate, or cGMP, from breaking down. With more cGMP present, the smooth muscles lining the walls of blood vessels are able to relax. The ultimate result is vasodilation and increased blood flow. The scientists who discovered how PDE5 inhibitors work were actually awarded the Nobel Prize in Physiology or Medicine in 1998. With PAH, the reasoning is, if Cialis can promote better blood flow to the genitals, why not to other arteries, like the pulmonary arteries?

What Does Ambrisentan Do?

Ambrisentan (sold under the brand name Letairis in the United States) is a drug that is already used to treat PAH. Ambrisentan is what’s known as an endothelin receptor antagonist. Endothelin is a peptide that constricts the smooth muscles in blood vessels. Since ambrisentan helps block the action of endothelin, it keeps blood vessels from constricting, and in people with PAH, it has the effect of improving exercise capacity. It’s been available since 2007 and is considered an “orphan drug” — a drug specifically developed to treat a rare medical condition (“orphan condition”).

Combining Cialis and Ambrisentan

The manufacturers of ambrisentan and Cialis jointly sponsored research to see if the combination of the two drugs might be better than either one individually in treating PAH. In a study of 500 people with PAH that took place from 2010 to 2014, around half of study participants received both drugs, while one-quarter received Cialis alone and another one-quarter received ambrisentan alone.

Of those taking both drugs together, only about 18 percent experienced severe progression of their PAH or died, compared with 31 percent of patients taking either one of the drugs alone. Furthermore, using the two drugs together did not appear to produce additional side effects. The study treated people with PAH who had not been treated for it before, and the combination of Cialis with ambrisentan significantly reduced the risk of “clinical failure” compared with the use of either drug alone.

Sildenafil Also Used to Treat PAH

Sildenafil, the active ingredient in Viagra, is also sold under the trade name Revatio as a treatment for PAH, and has been for several years, so it’s no big surprise that Cialis, which works in the same way as Viagra, would be useful as a treatment for PAH. Though both Cialis and Viagra are in the PDE5 inhibitor drug family, they’re formulated slightly differently. That’s why Cialis advertises itself as “The Weekend Pill” due to its longer half-life in the body than Viagra. Whether Cialis or Viagra is better at treating PAH is not yet known. It may be that one drug works better in some people, and the other works better in others. This is often the case with erectile dysfunction, with men typically finding that one drug works better than another.

Conclusion

The drugs used to treat erectile dysfunction may have revolutionized the conversation surrounding the condition. But it’s possible that these drugs may have far-reaching effects in treating a wide range of other medical conditions. In addition to treating PAH, sildenafil (Viagra) has been used to treat altitude sickness, menstrual cramps, and even a disfiguring benign tumor in children. “Miracle drug” may not be too strong a term for drugs in the PDE5 family.

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