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generic viagra Patients with increased susceptibility to vasodilators include those with left ventricular outflow obstruction (aortic stenosis, hypertrophic obstructive cardiomyopathy) or those with the rare syndrome of multiple system atrophy manifesting as severely impaired autonomic control of blood pressure.
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Hence, physicians may wish to consider the cardiovascular status of the patient before initiating any treatment for erectile dysfunction.
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However, prior to prescribing sildenafil, hysicians should carefully consider whether their patients with certain underlying conditions could be adversely affected by such vasodilatory effects, especially in combination with sexual activity.