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

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 dis-eases 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 car-dioprotective effects of PDE-5 inhibitors, which include different models and mechanisms and do not indi-cate 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, myocar-dial infarction, cardiac hypertrophy, cardiomyopathy and systolic and diastolic congestive heart failure. There-fore, this and similar reviews can help for additional clinical targeting in the therapy of cardiovascular diseases.