Consistent control is the benchmark for BP drugs

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June 19, 2019 - 10:03 AM

Dear Dr. Roach: Short of sounding like a conspiracy theorist, why hasn’t the Food and Drug Administration approved sildenafil in a set dosage for blood pressure medication? I saw a decrease from 150/90 to 115/70 in a reading about an hour after taking a 20-mg tablet. That’s a far superior result compared with the medications I am on. — J.I.C.

Answer: Sildenafil (Viagra) does have a blood-pressure-lowering effect in many men. However, the average effect is only about 8 points systolic and 6 points diastolic, far less than the 35 and 15 point drop you saw. Further, the blood pressure effect is gone in less than 8 hours. The goal for blood pressure medicine is continuous lowering without big ups and downs.

I’m not a big believer in conspiracy theories. If the medication were truly safe and effective for blood pressure control, you can be sure it would be marketed as a blood pressure pill with additional benefits for some people, just as tadalafil (Cialis) is marketed as a treatment for benign prostate enlargement, in addition to its proven role in treating erectile dysfunction. Tadalafil is also being studied as a potential benefit in heart failure treatment.

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