MEDIX, God. 14 Br. 79  •  Pregledni članak  •  Interna medicina HR ENG

Liječenje erektilne disfunkcije inhibitorima fosfodiesteraze 5 kod kardiovaskularnih bolesnikaPhosphodiesterase-5 inhibitors in the treatment of erectile dysfunction in cardiovascular patients

Darko Počanić

Incidencija erektilne disfunkcije je visoka među osobama s kardiovaskularnim bolestima: oko 68% uz hipertenziju te oko 75% uz koronarnu bolest srca. Sigurnost primjene PDE5-inhibitora kod bolesnika s dobro kontroliranom hipertenzijom jednaka je kao u normotenzivnih osoba iste dobi, a učinak istodobne primjene s antihipertenzivima je uglavnom neutralan do blago aditivan, osim u kombinaciji s doksazosinom. Bolesnici s koronarnom bolesti srca koja je stabilna, šest tjedana nakon preboljelog infarkta miokarda bez simptoma i nakon koronarne revaskularizacije mogu uzimati PDE5- inhibitore, kao i kardiološki bolesnici s blagom valvularnom bolesti, početnom disfunkcijom lijeve klijetke te benignim poremećajima ritma. Pacijenti s nestabilnim ili nereguliranim kardiovaskularnim bolestima moraju se podvrći kardiološkoj obradi radi procjene ukupnog i kardiovaskularnog rizika. Kod svih kardioloških bolesnika koji uzimaju PDE5-inhibitore apsolutno je kontraindicirana istodobna primjena donatora NO (nitroglicerina, isosorbid mono i dinitrata)

Ključne riječi:
koronarna bolest srca; erektilna disfunkcija; hipertenzija; PDE5 inhibitori

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 14 Br. 79

Erectile dysfunction among patients with cardiovascular diseases is present in up to 68% of patients with hypertension and up to 75% of patients with coronary artery disease. Safety of treatment with phosphodiesterase-5 (PDE5) inhibitors in patients with well-controlled hypertension is well established and comparable to that in age-matched normotensive patients. There is no or mild additive effect of co-administration of PDE-5 inhibitors and antihypertensive agents, except for doxazosine. PDE5 inhibitors may be safely administered in patients with stable coronary artery disease, asymptomatic patients six weeks after myocardial infarction, patients after revascularization, and patients with mild valvular disease or systolic dysfunction or benign arrhythmias. In unstable patients, risk stratification is required. Co-administration of NO donors (nitroglycerine, isosorbide-mononitrate or dinitrate) and PDE5 inhibitors is contraindicated and should be strictly avoided.

Key words:
coronary artery disease; erectile dysfunction; hypertension; phosphodiesterase inhibitors