Phosphodiesterase-5 Inhibitors as Therapeutics for  Cardiovascular Diseases: A Brief Review

Milena Corbic; Jasmina  Sretenovic; Vladimir  Zivkovic; Vladimir  Jakovljevic; Tamara Nikolic  Turnic

doi:10.18502/ijph.v52i5.12704

Milena Corbic Department of Neurology, Agnes Karll Laatzen Hospital, Laatzen, Germany
Jasmina Sretenovic Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Vladimir Zivkovic Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Vladimir Jakovljevic Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Tamara Nikolic Turnic Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

DOI: https://doi.org/10.18502/ijph.v52i5.12704

Keywords: Cardiovascular disease; Cardioprotective effects; Phosphodiesterase-5 inhibitors

Abstract

Background: Three selective and most used inhibitors of PDE-5- sildenafil, vardenafil and tadalafil- have been successfully used for the treatment of erectile dysfunction. Erectile dysfunction and cardiovascular diseases might be considered as two dissimilar clinical signs of the identical systemic disease. PDE-5 inhibitors can through different models and mechanisms induce vasodilation, decrease apoptosis and cell proliferation, and they are widely present in various tissues that make them promising targets in a range of cardiovascular diseases.

Methods: PubMed was explored to identify papers published from 1990-2019, presenting data for the most used PDE-5 inhibitors (sildenafil, tadalafil or vardenafil) in treatment of cardiovascular diseases.

Results: This article analyses the therapeutic potentials of PDE-5 inhibitors in cardiovascular diseases and discusses mechanisms, possible risks and limitations. Comparable to earlier studies, newer studies suggest cardioprotective effects of PDE-5 inhibitors, which include different models and mechanisms and do not indicate an increased rate of significant cardiovascular adverse reactions. Dissimilarity in the pharmacokinetics and pharmacodynamics of PDE-5 inhibitors are significant to their risk- benefit profile and clinical use. Some of the studies suggesting infarct size reduction after PDE-5 inhibition described the especially close dose-effect relation, other studies dosage adaptation in drug- drug interactions.

Conclusion: PDE-5 inhibitors indicate the encouraging useful effects by ischemia/reperfusion injury, myocardial infarction, cardiac hypertrophy, cardiomyopathy and systolic and diastolic congestive heart failure. Therefore, this and similar reviews can help for additional clinical targeting in the therapy of cardiovascular diseases.