Tadalafil plus antihypertensives yield no excess risk of hypotension, cardiac events

The use of tadalafil with antihypertensive medications does not seem to cause an excess risk of hypotensive or cardiovascular outcomes in men with erectile dysfunction (ED), a recent real-world study has found.

Drawing from electronic health records of hospitals across the US, the researchers assessed 126,120 men prescribed with tadalafil and antihypertensive medications. The outcome of interest was the risk of hypotensive or cardiovascular outcomes, as determined by diagnostic codes and as compared against a matched cohort of controls (n=126,120) taking antihypertensives alone.

Hypotension occurred at a significantly lower rate in men with both tadalafil and antihypertensive medications (13.32 vs 17.20 per 1,000 person-years; incidence rate ratio [IRR], 0.79, 95 percent confidence interval [CI], 0.71–0.89). The same was true for ventricular arrhythmia or cardiac arrest (4.98 vs 6.65 per 1,000 person-years; IRR, 0.79, 95 percent CI, 0.66–0.94).

Other cardiovascular events likewise occurred at lower frequencies in the tadalafil group, though the difference in incidence fell short of significance.

In addition, death from any cause (0.76 vs 1.51 per 1,000 person-years; IRR, 0.55, 95 percent CI, 0.36–0.86) and dizziness or fainting (30.71 vs 35.59 per 1,000 person-years; IRR, 0.88, 95 percent CI, 0.81–0.95) were both significantly less common in men who were prescribed tadalafil.

“This study did not demonstrate an increased risk of hypotensive/CV outcomes in patients with co-possession of tadalafil and antihypertensive medications beyond that observed among patients in possession of antihypertensive medications only,” the researchers said.