What is the priority of Viagra's "heart" and "kidney"

In September 2019, a video was wildly spread on the Internet: Xiaoya, an 8-year-old girl from Xuchang, Henan Province, attracted the attention of pharmacists when she went to the drugstore to buy ten boxes of sildenafil citrate (commonly known as "Viagra") When she asked the reason, she replied that she had taken it herself Her mother came to bear tears and explained that Xiaoya was a patient with pulmonary hypertension Other drugs were too expensive to rely on "Wei" Elder brother has been taking maintenance treatment for 5 years On December 7, the Yangcheng International Forum on pulmonary hypertension (2019) was held in Guangzhou Zhong Nanshan said at the meeting, "from the perspective of treating pulmonary hypertension, it is recommended that Viagra drugs enter the medical insurance." Because it is effective and relatively cheap compared with other imported targeted drugs " The move prompted a group of people living on Viagra - based drugs to quickly draw attention to pulmonary hypertension When it comes to Viagra, many male compatriots may be familiar with it It's a good medicine for husband and wife's harmony to treat "impotence" (male erectile dysfunction, ED) Viagra is used to treat pulmonary hypertension It is believed that the general population is relatively unfamiliar Pulmonary hypertension is a rare disease with a prevalence of 15-60 per 1 million people Pulmonary hypertension is a kind of pulmonary vascular disease Patients often have blue purple lips due to lack of oxygen, so they are called "blue lips" With the continuous increase of pulmonary vascular resistance, it eventually leads to heart and respiratory failure and death Therefore, pulmonary hypertension is also called "cancer in the field of cardio cerebrovascular" The original intention of Viagra's journey of heart: I originally walked in the heart, how could I walk in the kidney "Viagra" was initially developed as an anti coronary vasodilator, but in subsequent clinical studies, it was found that male subjects had an "adverse reaction" of sustained penile erection, which also put Viagra on the road of "kidney" However, the role of sildenafil in cardiovascular disease has not been stopped Scientists found that sildenafil has a positive effect on the expansion of pulmonary blood vessels in later studies, and it also embarked on the road of treating pulmonary hypertension How to treat pulmonary hypertension? Pulmonary blood vessels contain a large number of 5-phosphodiesterase, which is a degradation enzyme of cGMP Its inhibitor can relax blood vessels through no / cGMP pathway Sildenafil is the inhibitor of this enzyme It can relax the muscle of pulmonary artery, relax the pulmonary artery, reduce the pressure of pulmonary artery, and enhance the contractile force of heart muscle, so as to improve the situation of pulmonary artery high pressure China has not approved to change the use of "Viagra" manual, but only to treat erectile dysfunction However, it can also refer to the recommended application of China Lung hypertension diagnosis and treatment guide 2018 [1]: precautions for using Viagra 1 Sildenafil can enhance the antihypertensive effect of nitrates, and it is forbidden to use it with nitrates or other drugs that can provide nitric oxide; 2 It is forbidden to use it with guanosine cyclase agonists (such as lyoxygenase, also used for the treatment of pulmonary hypertension), which may cause symptomatic hypotension; 3 Transient visual abnormalities may occur, mainly manifested as light, but also increased sensitivity to light or blurred vision [2] Exercise for life management of patients with pulmonary hypertension: after the drug treatment is stable, exercise can be carried out under the supervision of doctors, which is helpful to enhance the ability of oxygen metabolism of skeletal muscle, improve the stability of heart function and blood flow, and reduce the deterioration of pulmonary artery [3]; Psychological support: with the development of pulmonary hypertension, and the cost of treatment is large, it may have a significant impact on patients' psychological, emotional and mental state Patients should be encouraged to be optimistic about the response to the disease and improve the compliance of the treatment drugs; prevention of infection: pulmonary hypertension patients are prone to pneumonia, about 7% of pulmonary hypertension patients died of pneumonia, and it is recommended to inject influenza and Streptococcus pneumoniae vaccine for prevention [4] 【1】 Pulmonary vascular group, cardiovascular branch of Chinese Medical Association, editorial board of Chinese Journal of cardiovascular disease Chinese guidelines for diagnosis and treatment of pulmonary hypertension 2018 [J] Chinese Journal of cardiovascular disease, 2018,46 (12): 933-964 [2] instructions for sildenafil citrate tablets [3] lauemt, tamuray, mcgononmd, etal.The2015ESC/ERSGuidelinesforthediagnosisandtreatmentofpulmonaryhypertension:apracticalchronicleofprogress[J].EuropeanRespiratoryJournal,2015,46(4):879-882 【4】GalièN,ChannickRN,FrantzRP,etal.Riskstratificationandmedicaltherapyofpulmonaryarterialhypertension[J].EurRespirJ,2019, 53 PII: 1801889 Responsible editor | penicillin statement: This article is the original article of Yaozhi online, the point of view only represents the author, not the position of Yaozhi online, welcome to exchange and supplement in the message area; if you need to reprint, please be sure to indicate the author and source of the article.