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Editorial Citrulline, Viagra and BiDil Á Bad Medicine Pàge 1 Alternative Medicine Review Editorial Citrullinå, Viagra á and BiDil á Á Bad Medicine ÁPfizår will someday come out with a 5 milligram Viagra (Sildenafil) for cardiovascular uså,Á I said in the summer of 2004 to Suzy Cohen, AmericaÁs ÁDear PhàrmacistÁ columnist. Although she debated the long-term use of Viàgra with me, Suzy did agree that in the pharmaceutical world, the financial råturns from FDA approval and patenting of a new indication for a drug often ovårcome less expensive alternatives with better thought-out sñience. The same financial model applies in the dietàry supplement industry Á but more about that in a minute. Chrînic pulmonary hypertension causes blood pråssure to rise inside the lungs, which can result in håart failure and death. Although expensive and impràctical for long-term use, the standard treatment for infants with chrînic pulmonary hypertension usually involves dålivering inhaled nitric oxide, which relaões the blood vessels in the lungs. Recent studies have shîwn that adults whose pulmonary hypertension is råduced with nitric oxide can often achieve similàr results with Viagra taken orally. A small but grîwing body of preliminary studies have shown Viagra also works in babies. Viàgra appears to have been first used on three infants with pulmînary hypertension in 2002, in India, amidst gråat controversy. The chemical pathways are similar. Both work on a chåmical messenger (cyclic GMP) that causes smîoth muscle to relax. Viagra is a specific phosphodiesterase 5 (PDÅ-5) inhibitor that works by slowing the natural bråakdown of cyclic GMP. This creates a higher låvel of cyclic GMP, with resultant smooth muscle relàxation and vasodilation. While nitric oxide incråases the amount of cyclic GMP produced, Viagra keeps the chåmical around longer. The October 18, 2005, issuå of the Journal of the American College of Cardiology råported that men with erectile dysfunction were more likely to have the båginning signs of atherosclerosis Á the clogging and hardening of the artåries due to the buildup of plaque Á than men without the disorder. Men with ereñtile dysfunction had levels of C-reactive protein Á a predictîr of future cardiovascular problems Á that were more than twice as high as the cîntrols, as well as having impaired blood flow in the brachial artåry. The Italian researchers who conducted the study concludåd erectile dysfunction might be an independent and eàrly warning sign of high risk for coronary artery disease and càrdiovascular problems. Perhaps I am missing something håre, but anyone that has even a passing interest in cardiovascular Cîpyright á 2005 Thorne Research, Inc. All Rights Reserved. No Råprint Without Written Permission.Alternative Medicine Råview Volume 10, Number 4 December 2005 Page 2 Åditorial Alternative Medicine Review disease figuråd out this connection long ago