Question 275 of 433
Does a daily low dose of Cialis (tadalafil) extend life?
The short answer
It might. Large database studies link it to fewer heart attacks, less dementia, and lower death rates. No randomized trial has tested it for prevention, so it remains a hypothesis.
Tadalafil relaxes blood vessels by raising a signaling molecule called cyclic GMP. A daily dose of 2.5 to 5 milligrams is approved for erectile dysfunction and for urinary symptoms from an enlarged prostate. Drugs of this class were first studied for heart disease, and tadalafil is used at higher doses for high blood pressure in the lungs.
The observational evidence is consistent. In a study of more than 70,000 American men with erectile dysfunction, those prescribed this class of drug had about 13 percent fewer major heart events and 25 percent lower death rates. A Swedish study of men after a heart attack found the same direction. A British study found about 18 percent less Alzheimer’s disease among users.
The caution is equally consistent. Men who are prescribed these drugs tend to be healthier, wealthier, and more sexually active to begin with, and that alone predicts longer life. Only a randomized trial can separate the drug from the man.
Safety matters here: it must never be combined with nitrates, it can drop blood pressure when taken with certain prostate medicines, and it causes headache, flushing, reflux, and back pain in some men. Rarely it affects vision or hearing.
My position: for a man who already has erectile difficulty or prostate symptoms, a daily low dose is reasonable, and the possible heart benefit is a welcome extra. For a man with neither, or for a woman, I would wait for a trial.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
ROBUST for approved symptom indications; OBSERVATIONAL for cardiovascular and dementia associations; longevity use unproven.Evidence grade (draft mapping)CObservationalARobust human trialsPart 19, Q275 · Part sources
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.