Can Viagra Cause a Heart Attack?

Reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Updated 15/02/2022

Though Viagra is widely considered safe when used properly, you may have heard that ED meds  can make existing heart disease worse or even cause heart attack.

While it may not be obvious, erectile dysfunction medication does have a direct impact on your cardiovascular system. This is because drugs like Viagra cause vasodilation, meaning they work by relaxing muscles and arteries across your whole body — not just in your penis. 

Below, we’ve delved into the subject of Viagra and its effect on your heart. We’ll address concerns about Viagra interacting with heart medication and whether it is safe for men with heart problems. And, we’ll answer the question of whether Viagra can cause a heart attack.

So, Can Viagra Cause a Heart Attack?

Well, no. Although many people speculate that Viagra can cause heart attacks, there is no official documented evidence of such an adverse event.

However, men with existing heart conditions and those who are taking heart medications should avoid or exercise caution when taking erectile dysfunction drugs. 

A heart attack, also known as a myocardial infarction, occurs when blood flow to part of the heart muscle is interrupted. Some of the most common symptoms of heart attack include chest pain, weakness, shortness of breath and pain or discomfort in the back, arms or shoulders. 

In most cases, a heart attack is the result of atherosclerosis — the narrowing of the arteries caused by the buildup of fat, cholesterol and other substances. The arteries supplying blood to the heart become closed off, cutting off blood flow to the heart. 

However, because Viagra is a vasodilator, it helps open up blood vessels and arteries. You might think that this would actually help to reduce the risk of a heart attack, but, there have been reports of heart attack, stroke, arrhythmia and even death in men taking Viagra. 

It’s important to note that this apparent correlation between heart attack and Viagra use does not mean that Viagra is actually causing the heart attack.

Some experts cite the results of a 2002 study published in the journal, JAMA, to support the theory that heart attacks linked to Viagra were more likely related to the performance of sexual activity (specifically in patients with coronary artery disease) than to the use of the drug.

In this study, sildenafil had no effect on symptoms during exercise in men with stable coronary artery disease. 

Heart Disease and ED: The Real Culprit?

While there is no evidence that directly links Viagra to a heart attack, there may be a link between erectile dysfunction and heart disease. 

According to Harvard Health, erectile dysfunction can sometimes serve as a warning sign for men with underlying heart conditions.

This is because both erectile dysfunction and many heart issues (heart attack, chest pain or angina, strokes, and other conditions) can be caused by the same issue - atherosclerosis. 

Like we said before, atherosclerosis happens when arteries narrow due to fat and cholesterol buildup, causing the arteries to fail at serving as a vessel for blood flow. If blood can’t reach the heart, or the penis, you can run into issues. 

If you are experiencing erectile dysfunction, there could also be underlying heart issues to talk to your healthcare provider about. 

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Viagra and Heart Disease: Is it Safe?

Because erectile dysfunction and heart conditions are linked, it is important to consider the link between erectile dysfunction treatment and heart conditions. The concern is the drug’s effect on the arteries, according to Harvard Health

Though Viagra is intended to work on the arteries in the penis, its effects are systemic. All arteries in the body produce nitric oxide, so Viagra could potentially trigger vasodilation in other arteries, like those surrounding the heart, which could cause a temporary drop in blood pressure by 5 to 8 mmHg. 

However, whether Viagra is safe for men with heart disease depends on the individual. For many men with heart disease, a minor drop in blood pressure of up to 8.3 / 5.3 mmHg would not be considered dangerous. 

For certain heart conditions, however, it could be. This may be the case for severe heart failure, aortic stenosis, hypertrophic cardiomyopathy, ischemia, and pulmonary veno-occlusive disease. 

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Viagra and Heart Medications: Interactions

Like other prescription medications, there is a risk of side effects from Viagra. These are generally mild and temporary, though interactions with other prescription medications can be serious.

However, there is also a risk of interaction with other medications. Because Viagra was originally developed as a treatment for pulmonary hypertension, it may interact poorly with other heart medications. 

The manufacturer, Viatris, suggests men taking nitrates and guanylate cyclase stimulators should not take Viagra.

Nitrates are typically prescribed for angina  (chest pain) and guanylate cyclase stimulators like Adempas® (generic riociguat) are prescribed for pulmonary hypertension. 

Pairing Viagra with these medications may cause your blood pressure to drop to an unsafe level, according to an article published in the Journal of Family and Community Medicine. Similarly, patients who have recently taken Viagra should not be given nitrates. 

However, even for men not taking nitrates, there has been some concern surrounding whether Viagra might make underlying heart conditions worse. 

Given the known interactions between Viagra and heart medications, the FDA has urged caution in patients who have experienced heart attack, stroke or other serious cardiovascular events within six months. 

Men with a history of congestive heart failure, low blood pressure or uncontrolled high blood pressure should exercise caution, as well. 

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Viagra and Your Heart

Talk to your healthcare provider about the potential risks before taking Viagra. Make sure to tell them about any medication, both prescription and non-prescription, you may be taking, and about any underlying health conditions you have. 

For more information about Viagra (sildenafil) warnings, check out our blog.

You might also want to read our guide to the most common ED treatments before seeking medical advice from your healthcare provider so you understand the options.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.

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