Sildenafil does not reliably improve exercise performance in hypoxia: a systematic review

Area of Science:

• Exercise Physiology
• Pharmacology

Background:

• Sildenafil, a pulmonary vasodilator, is investigated for its potential to mitigate endurance performance decline in hypoxic conditions.
• The study aims to evaluate sildenafil's efficacy in improving exercise performance under hypoxia.

Approach:

• A systematic review and meta-analysis of randomized controlled trials comparing sildenafil to placebo in hypoxia.
• Included 14 studies with 210 participants receiving sildenafil (40, 50, or 100 mg/day).
• Assessed effects on pulmonary artery pressure (PAP), cardiac output (CO), and pulse oxygen saturation (SpO2).

Key Points:

• Sildenafil significantly reduced PAP at rest and during exercise.
• A moderate effect was observed on increasing SpO2, with a small effect on CO.
• Performance enhancement was minimal, particularly in normobaric hypoxia compared to hypobaric conditions.

Conclusions:

• Sildenafil effectively reduces pulmonary artery pressure in hypoxic environments.
• The drug demonstrates a moderate to small impact on cardiac output and oxygen saturation.
• No significant improvement in endurance performance was found with sildenafil use in hypoxia.