Erectile dysfunction pills may increase the risk of death with long-term use. When taken in combination with cardiovascular medications, the risk increases. Erectile dysfunction is most commonly treated with the drugs PDE5i, or phosphodiesterase type 5 inhibitors. A new scientific study conducted by a team at the Karolinska Institute in Stockholm, Sweden, looks at the risk of long-term use of these drugs. Erectile dysfunction in men is a strong predictor of coronary artery disease. Erectile dysfunction medications also help with heart health. Nitrates are other drugs that are prescribed for angina or chest pain. Both types of drugs have the same side effect – sharp drops in blood pressure, so using them in combination can potentially harm heart health. The results of the scientific study show that the use of both types of medication leads to an increased risk of all health conditions considered and death, compared to the use of nitrates alone. Conditions such as myocardial infarction, heart failure, cardiac revascularization have been investigated. Use of PDE5i drugs alone has a greatly reduced risk. Erectile dysfunction has more than one possible cause. In some cases, it occurs as a result of problems with the vascular system – blood flow to the penis (this is the most common cause). But erectile problems can also be based on problems in the nervous system � damage to neurons that prevents signals from traveling to the penis that cause an erection. Problems with hormone levels (especially testosterone) also potentially lead to erectile dysfunction. Such problems can occur as a result of a wide range of diseases – type 2 diabetes, hypertension, high cholesterol levels, atherosclerosis, stroke and epilepsy. Direct physical trauma to the penis or surrounding areas of the body can also cause problems – this includes injuries to the hip bones, lower back and tail, as well as problems with the bladder, prostate and spinal cord. Most often, erectile problems occur in middle or old age. Then it is more likely that the man suffering from erectile dysfunction is taking medications such as nitrates for heart problems. Using both types of medication in combination is something that can temporarily improve symptoms, but in the long term increase the risk of death. References: Lagerros, Y. Risk of Death in Patients With Coronary Artery Disease Taking Nitrates and Phosphodiesterase-5 Inhibitors. https://www.jacc.org/doi/10.1016/j.jacc.2023.10.041