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Viagra Is Good for the Heart

by: Rita Jenkins

Copyright 2005 Daily News Central

Viagra (Sildenafil citrate), which millions of men take for erectile dysfunction (ED), reduces the effects of hormonal stress on the heart by half, according to a study published online in the journal Circulation.

Viagra causes genital blood vessels to expand, which helps in maintaining an erection. Recent research also has pointed to its potential usefulness in treating pulmonary hypertension. Prior to the latest findings by a team of Johns Hopkins researchers, it was thought to have little effect on the heart.

Viagra, or sildenafil, blunts the strengthened heart beat caused by chemically induced stress, according to study senior author and cardiologist David Kass, MD, a professor at the Johns Hopkins University School of Medicine and its Heart Institute. It thereby lessens both the excess amount of blood and the force used to pump it to the body.

"Sildenafil effectively puts a 'brake' on chemical stimulation of the heart," says Kass.

Prevents and Reverses Effects of High BP

These findings are believed to be the first confirmation in humans that Viagra has a direct effect on the heart. In earlier research, Kass and his team observed a similar effect in mice; Sildenafil blocked the short-term effects of hormonal stress in the heart.

Related studies by the group show that sildenafil also prevents and reverses the long-term effects of chronic high blood pressure on the heart.

Sildenafil reversed the negative effects on heart muscle weakened by heart failure and enlargement -- a condition called hypertrophy -- in mouse experiments Kass and his team carried out earlier this year. They reported their results in the journal Nature Medicine.

"But we had no firm evidence as to whether or how this therapy might work in the human heart," says Kass. "Our latest research provides firm evidence this drug does indeed have an important impact on the heart."

Increased Heartbeat Was Slowed

Thirty-five healthy men and women, with an average age of 30 and no previous signs of coronary artery disease, participated in the six-month Johns Hopkins study. Within a three-hour timeframe, each participant received two separate injections of dobutamine (5 micrograms per kilogram for five minutes), a synthetic, adrenaline-like chemical that increases heart rate and pumping strength.

Between injections, study participants were assigned randomly to a group that was treated with sildenafil (100 milligrams taken orally) or to a group given a sugar pill placebo. All participants then were given the second dobutamine injection to see what effects sildenafil or placebo had on the heart.

Measurements of heart function were made before and after each injection. These included blood pressure readings, electrocardiograms and echocardiograms. Blood samples confirmed relatively equal levels of sildenafil and other enzymes.

Each dobutamine injection stimulated heart function, increasing heart rate and the force of each heartbeat used to pump blood throughout the body, results showed.

"This stimulation is similar to the way the nervous system normally increases heart function when triggered by emotional or exercise stress, or in diseases such as heart failure," notes Kass.

After the first injection of dobutamine, the force of heart contraction increased by 150 percent in both groups. In the placebo group, this increase repeated itself after the second injection. However, in the group treated with sildenafil, the increased heartbeat was slowed by 50 percent, resulting in a smaller increase in blood flow and blood pressure generated by the heart in response to chemical stimulation.

Between injections, heart function was not altered in the sildenafil group, demonstrating the absence of adverse side effects on the resting human heart.

Stops PDE5A Action

"Knowing more about the effects of sildenafil on heart function will allow for safer evaluation of its use as a treatment for heart problems," says Kass.

"Our results set the stage for further studies of sildenafil's immediate and long-term effects on the heart and its ability to modify other neurohormonal and stress stimuli, including adrenaline and hypertension," he adds.

While the precise biological actions of sildenafil in the heart are not fully understood, the drug is known to work by stopping the action of an enzyme, called phosphodiesterase 5 (PDE5A), Kass explains. This enzyme is involved in the breakdown of a key molecule, cyclic GMP, which helps control stresses and limit overgrowth in the heart.

PDE5A is also the biological pathway that sildenafil blocks in the penis to prevent the relaxation of blood vessels and thus maintain erections.

About the author:
Rita Jenkins is a health journalist for Daily News Central, an online publication that delivers breaking news and reliable health information to consumers, healthcare providers and industry professionals:

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Mom's Job Stress May Spread to Kids
by: Rita Jenkins

Low job satisfaction in working mothers increases the stress levels of their children, but allowing them to spend more time in childcare can help overcome these effects, according to new research published in Developmental Psychobiology.

Children whose mothers found their jobs emotionally exhausting or otherwise less rewarding had higher levels of the stress hormone cortisol than children whose mothers reported more enjoyment from their jobs, researchers found in a study involving more than 50 nursery school children.

Levels of cortisol in the evening were more than double in the children whose mothers experienced less job satisfaction. Placing those children in childcare would help to significantly reduce their stress, the research suggests.

The researchers also found that children from families that were either highly expressive or very reserved exhibited higher than average cortisol levels.

Greater support is needed for working mothers to help improve their job satisfaction and increase the availability of affordable childcare options, says the report.

More Time in Childcare

Dr. Julie Turner-Cobb, a health psychologist and senior lecturer at the University of Bath, Dr. Christina Chryssanthopoulou from the University of Kent and Dr. David Jessop, a neuroimmunologist at the University of Bristol collaborated on the study.

To measure cortisol levels, they took saliva samples in the morning and evening from 56 children aged three to four years old. They also surveyed mothers about their workplace conditions and home life over a six month period.

"Spending more time in childcare makes a big difference to the stress levels in children whose mothers have low job satisfaction," says Dr. Turner-Cobb.

"It can help protect children from the effects of their mother's low job quality and emotional exhaustion. Ensuring that mothers of young children have good support in the workplace is essential for supporting both mothers and their children," she adds.

"Improving the job satisfaction of working mothers means that they are less stressed themselves," says Dr. Jessop, "and extending the availability of affordable and adequate childcare may not only improve the quality of life for the mothers but, in doing so, may improve the long term health of their children."

Healthy Adaptation to Stress

Cortisol is a steroid hormone that regulates blood pressure and cardiovascular function and immune function. It also controls the body's use of proteins, carbohydrates and fats.

Cortisol secretion increases in response to stress, whether physical -- such as illness, trauma, surgery or temperature extremes -- or psychological. It is a normal and essential response without which we would not be able to function in everyday life.

When these levels remain high or become disrupted in some way over a prolonged period of time, however, they may have consequences for health. It is important to promote healthy adaptation to stress in children, and good quality childcare is one way of doing this, say the authors.

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