Sildenafil is safe in men with Class II and III congestive heart failure for treatment of erectile dysfunction and depression, according to results of a prospective, placebo-controlled, double-blind crossover trial published in the March 8th issue of the Archives of Internal Medicine.

Many men with congestive heart failure also have erectile dysfunction, and their condition is often complicated by symptoms of depression. Findings from the current study suggest sildenafil can be effective in improving erectile dysfunction and depression in this population, resulting in an improved sense of quality of life.

Roughly 52 percent of men aged 40 to 70 years are affected by erectile dysfunction, with pathogenesis related to aging and peripheral vascular disease. Depression is so common that many researchers believe the three problems make up a negatively mutually reinforcing clinical triad.

"Congestive heart failure is difficult to live with in that they must take numerous medications, their activity is hindered because of shortness of breath and fatigue, and ultimately though treatable, there is no cure," said Linda Webster, MSN, lead author of the study. "The inability to perform sexually can cause depression alone and of itself."

The American research team enrolled 35 men for the 12-week trial after confirmation via exercise stress test or nuclear perfusion scan that there was no ischemic cardiac disease. Sildenafil use was associated with an asymptomatic decrease in blood pressure and improved scores on the International Index for Erectile Function survey, improved scores on two scales for depression, and improvement in the Minnesota Living with Heart Failure Questionnaire.