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Along with improving their performance between the sheets, Viagra could also make men live longer, a study reveals.

Men who have survived a heart attack could lower their risk of another the longer they take the impotence drug, it adds.

Impotence can be an early warning sign of cardiovascular disease and is treated with alprostadil, which dilates the blood vessels so that the penis stiffens, or so-called PDE5 inhibitors such as Viagra or Cialis tablets.

Since both decrease blood pressure, they were not recommended for men with coronary artery disease due to the risk of heart attack.

Prof Martin Holzmann and his team at Sweden’s Karolinska Institutet compared the effect of alprostadil with PDE5 inhibitors, including Viagra, in 18,500 men with stable coronary artery disease.

They found those receiving PDE5 inhibitors lived longer and had a lower risk of another heart attack or failure than those who took alprostadil.

Since Viagra and Cialis decrease blood pressure, they were previously not recommended for men with coronary artery disease due to the risk of heart attack.

But in 2017, Prof Holzmann and colleagues showed that men who have had a heart attack tolerate the drug well and that it even prolongs life expectancy and protects against stroke and heart failure.

In their new study, the team compared the effect of alprostadil and PDE5 inhibitors including Viagra in men with stable coronary artery disease.

The patients had either a stroke, balloon dilation or a coronary artery bypass surgery at least six months before starting treatment for erectile dysfunction.

Prof Holzmann said: ‘The risk of a new heart attack is greatest during the first six months, after which we consider the coronary artery disease to be stable.’

The study included 16,500 men treated with PDE5 inhibitors and just under 2,000 who received alprostadil.

Data was collected from the patient, drug and cause of death registries.

Men who received PDE5 inhibitors lived longer and had a lower risk of new heart attack, heart failure, balloon dilation and bypass surgery than those who received alprostadil.

Prof Holzmann said: ‘This suggests that there’s a causal relationship, but a registry study can’t answer that question.

‘It is possible that those who received PDE5 inhibitors were healthier than those on alprostadil and therefore had a lower risk.

‘To ascertain whether it is the drug that reduces the risk, we would need to randomly assign patients to two groups, one that takes PDE5 and one that doesn’t.

‘The results we have now give us very good reason to embark on such a study.’

As Viagra and other PDE5 inhibitors are available by prescription only in Sweden, they cannot be bought over the counter.

But Prof Holzmann hopes that men with coronary artery disease do not shy away from addressing the matter with their doctor.

The research was published in the Journal of the American College of Cardiology.

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