A paper published in the American Journal of Medicine, funded by the National Institute of Health in 2024, evaluated the use of Viagra and Cialis on mortality from cardiovascular disease and dementia. This study was done by the Department of Emergency Medicine, the Department of Internal Medicine, and the Department of Cardiology at the University of Texas, Galveston.
This was a three-year observation of mortality and men who were at least 40 years old who had self-reported erectile dysfunction or were taking these medications for urinary tract symptoms (ie, prostate issues). The dosages were chosen by their medical provider. Some were given as needed, while others were given daily. There were approximately 1,600,000 men in the study.
About two-thirds of the men were given 5 mg of Cialis daily (for erectile dysfunction or urinary symptoms), and about one-third were put on as-needed Cialis or Viagra for erectile dysfunction. As needed, the men used the drugs approximately two times per week.
Here’s what they found after three years:
- There was an over 30% reduction in all-cause mortality. This means the men taking Cialis or Viagra are more likely to be alive in three years than men with erectile dysfunction who did not take Cialis or Viagra.
- Men taking 5 mg of daily Cialis had a 38% reduction in all-cause mortality. There was a 30% reduction in strokes, a 25% reduction in blood clots, and a 31% reduction in dementia.
- Cialis was more effective than Viagra, and daily was more effective than as-needed in lowering the risk of death, blood, and dementia. These men also had a 33% reduction in the incidence of heart attacks.
While the cause of this life extension or death protection cannot be extracted from this article, one may ask, “Is it the increased sex or the drug that worked?”. It appears mostly to be the result of the drug because a large percentage of the men were taking the drug for urinary tract symptoms and not for erectile dysfunction.
When we look at other drugs that affect lifespan and people with diseases such as diabetes or people with hypertension, we see similar patterns. But even though borderline blood pressure or borderline diabetes do not quite meet the definition of a disease, there’s a benefit to medicating as if they have the disease. To put it another way, someone who does not meet the definition of diabetes but is a pre-diabetic is pretty much at a similar risk of diabetes complications as the actual diabetic. And if we treat pre-diabetics as if they were diabetic, they have less all-cause mortality. The same can be said for high blood pressure.
This is something that may come up from time to time, where someone is considering the pride of not taking medications versus accepting the fact that, as we age, we develop more diseases. And even before we developed the disease, we had a precondition for the disease. This study looked at people who met the definition of erectile dysfunction, and the reduction in death and disease is quite significant.
When discussing your concerns about erectile dysfunction with your doctor, there may be some hesitation to take medication for it. But when a drug is shown to reduce the chance of dying, reduce the chance of stroke, reduce the chance of heart attack, reduce the chance of blood clots, and reduce the chance of dementia by roughly a third, that makes the decision much easier.
In summary, Cialis is more effective than Viagra for mortality and disease reduction (but they both work). Daily versus as-needed is more effective for mortality and disease reduction (but they both work). Given the wide availability and the low cost of these drugs, I would have a very low threshold for prescribing these medications, who would not only wanna have a better sex life but they wanna live longer.
And let’s be real: you may think about the cost if your insurance doesn’t cover it, or whether you should even run it through your insurance because you’re not having bad enough erectile dysfunction. At the time this blog was written, a month’s supply of daily Cialis (generic) is $6.60 on the online Pharmacy Cost Plus.
Dr. Charles Mok
