How I Use Cialis to Heal Arteries (What your doctor won't explain)
In a Nutshell
Cialis (tadalafil), a PDE5 inhibitor, relaxes arteries by preserving nitric oxide's effects on blood vessels, originally developed for angina, and low-dose daily use (5mg) modestly lowers blood pressure, reduces inflammation, improves endothelial function, and aids LUTS/BPH—offering arterial health benefits beyond ED without reversing plaque (evidence from mice/observational data, not human trials). Integrate as a lifestyle adjunct after optimizing diet/exercise/sleep for high BP or insulin resistance; avoid with nitrates, recent heart events, or low BP, and watch for rare side effects like headaches, flushing, or vision issues. Not a first-line BP med or plaque cleanser; prioritize lifestyle (80-90% of results), combine cautiously with tamsulosin or citrulline, and never exceed 5mg daily.
These notes were generated by AI and may contain inaccuracies.
People think of Cialis as an ED medication, but it relaxes blood vessels and can help arteries if used correctly. It helps the body use nitric oxide more effectively, a main signal for arteries to relax and open up. Questions include: Can it open arteries to the heart and brain? Can low dose help circulation? Heart risk? Part of artery protection plan? Is it safe?
Discussion covers what Cialis-type drugs do to arteries, help with blood pressure and inflammation, fit into prevention plan, limits, safe use for good candidates. Not everyone should use it, especially some men. Dr. Brewer and Dr. Vega.
Cialis (tadalafil) lowers blood pressure, impacts nitric oxide safely. Originally developed for blood vessels, not sex. Sildenafil (Viagra) for angina (chest pain from heart artery constriction) because it affects vessel relaxation.
Endothelium (artery wall lining) and nerves release nitric oxide, triggering enzyme making cGMP (cyclic GMP) in smooth muscle cells, signaling artery wall muscle to relax. PDE5 enzyme breaks down cGMP. PDE5 inhibitors (sildenafil, tadalafil) block PDE5, protecting existing nitric oxide/cGMP from quick breakdown, leading to more relaxation and better blood flow in penis (corpora), pulmonary vessels, systemic vessels.
Does not enhance nitric oxide production; protects existing nitric oxide from PDE5 enzyme. Like offensive line protecting quarterback (nitric oxide) from linebackers (cGMP breakdown enzymes). PDE5 controls nitric oxide effect to prevent always-open vessels and very low blood pressure.
Developed for angina; side effect of better erections led to ED use, like minoxidil (blood pressure med repurposed for hair growth).
Arterial plaque culprits include metabolic disease causing high blood pressure via high insulin. Plaque buildup associated with high blood pressure, creating mechanical friction damaging endothelium (e.g., carotid artery split).
Tadalafil (Cialis) longer-acting than sildenafil (Viagra). Small temporary drop: single digits to low teens mmHg (e.g., 120/80 to 105/65, diastolic less). Peak wears off few hours (Viagra), longer (Cialis). Higher doses in resistant hypertension lower 24-hour ambulatory BP more, short-term. Not guideline-recommended BP drug: not studied enough, unreliable impact, lacks steady 24-hour control vs. ACE inhibitors (e.g., lisinopril, ramipril), ARBs (e.g., losartan), thiazide diuretics (e.g., hydrochlorothiazide/HCTZ), calcium channel blockers (e.g., amlodipine).
Most high BP idiopathic; first-line not just meds. Cialis may reduce BP, enhance nitric oxide for arterial health, anti-inflammatory properties on endothelium.
Some evidence but not conclusive; internet claims ahead of data.
Dr. Brewer (68-year-old man) takes 5 mg Cialis daily for LUTS (lower urinary tract symptoms: nocturia, ruining sleep). Also manages elevated BP, metabolic disease, BPH. Lifestyle improvements (e.g., 20+ lb loss) reduce/eliminate BP meds, but juggles: skips BP meds some days to avoid too-low BP, combines with 5 mg Cialis.
- Bart Robinson: 5 mg daily 10 years improves BP but not frequent urination/leakage at night.
- John Bondi: Can Cialis replace/supplement tamsulosin?
- Asparal flesh 6169: Afraid tadalafil causes stroke in husband.
LUTS: Can't hold pee, nocturia, leakage, urge, incomplete emptying.
Both relax prostate/urethra muscles for urine flow. Tamsulosin blocks alpha-adrenergic receptors (stimulation closes vessels), keeps vessels open. Cialis via nitric oxide. Can combine: Dr. Brewer uses daily 5 mg tadalafil + tamsulosin (Flomax) 1x/week initially, now 4x/week for better LUTS relief.
Tamsulosin relaxes esophageal sphincter, risks GERD. Every solution creates new problems. Growing old not for sissies, easier with healthier arteries. Lifestyle 80-90% effort; drugs extra push.
No seen cases of tadalafil causing stroke; online reports linked to overdosing. Poison is the dose.
Question about blurry vision on tadalafil (Cialis) and using citrulline instead. Vision problems with these drugs are unusual but serious—do not ignore them. If experiencing visual problems with tadalafil, stop taking it, as with Atlanta Skyline (Adcirca). Mechanism may involve the iris muscle.
Citrulline helps nitric oxide production. Dr. Lou Ignarro, Nobel Prize winner for discovering nitric oxide, takes citrulline daily in his 80s before workouts. Citrulline is less reliable for ED but has that reputation. It's helpful for workouts, arterial health, and recommended with creatine for people in their 60s dealing with sarcopenia (muscle loss).
Citrulline and arginine promote nitric oxide production, while tadalafil/Cialis ensure nitric oxide does its job (different pathways). Combining them theoretically risks excessive nitric oxide effects. Start with one at small doses; most side effects from tadalafil occur at 20mg or higher—5mg usually fine.
Safe to take 5mg daily tadalafil with citrulline; concern is theoretical, not supported by evidence.
Back of the eye has small vessels/nerves. PDE5 inhibitors increase blood flow/pressure there, potentially causing blurry vision or retinal damage (rare, usually high doses). Would like reports of blurry vision from 5mg dosing.
Nattokinase (from natto) decreases clotting mildly—not reliable antiplatelet like aspirin or blood thinner like Xarelto/Eliquis. For atrial fib (6-8x stroke risk), do not rely on it for stroke prevention—stroke worse than heart attack. Speaker takes Xarelto for atrial fib prevention.
In APOE knockout mice (no APOE gene; APOE4 increases heart attack/stroke risk), sildenafil (Viagra) improved endothelial function, reduced oxidative stress, and reduced aortic plaque.
Biologically plausible but jumping to humans premature. In humans, PDE5 inhibitors improve endothelial function, vascular reactivity (can double vasodilation), with sustained cellular effects beyond drug presence.
However, rigorous trials in humans with coronary artery disease: sildenafil did not significantly improve endothelium-dependent vasodilation or fibrinolytic (clot-clearing) function.
Observational data: men on PDE5 inhibitors have lower rates of heart attack, heart failure, mortality—but confounders like healthier men, more sexual activity, better care access.
Is there evidence tadalafil can clean arteries? Not in humans. Clear studies in mice, some observational in humans, but clinical trials fall apart.
Arterial health benefits: better vessel opening, lower blood pressure, reduced inflammation—not necessarily reversing plaque.
Use low-dose tadalafil (e.g., 5mg) if lifestyle optimized but still have high blood pressure/insulin resistance issues. Helps blood pressure control, inflammation reduction, better blood flow—not a one-pill fix for heart attacks/strokes. Treat as potent supplement; effects evident with constant use, but individualize—not daily medication reliance.
Lifestyle primary: diet king, plus exercise, sleep. Tadalafil supports sleep indirectly aiding arterial health—not direct like aspirin.
Never prescribe >5mg Cialis daily, even for ED events (higher doses riskier with age). Example: Dennis Smith lost 50lbs on low-carb, blood pressure down, cut center pearl (centripetal?) in half.
Lifestyle #1; meds/supplements for plateaus.
- Nitrates (nitroglycerin under tongue, spray, patches, isosorbide dinitrate/mononitrate): profound blood pressure crash, risk heart attack/stroke—do not combine (both increase cGMP).
- Riociguat (guanylate cyclase stimulators): same issue.
- Recent heart attack/stroke, unstable angina, severe heart failure, critical aortic stenosis, significant/unstable low blood pressure, severe liver/kidney disease (needs dose adjustment), sudden monocular vision loss from NAION or unexplained vision loss.
If on Cialis/Viagra during heart attack, tell EMS—they may give nitrates, causing lethal blood pressure drop.
Headaches, flushing, nasal congestion, indigestion, dizziness, visual disturbances, back/muscle pain, sudden hearing loss (rare), priapism (>4hrs erection)—go to ER for vision loss/priapism (rare at ≤5mg, more at 20mg+).
Explanations: flushing/headache/nasal congestion/dizziness from artery opening; indigestion from esophageal smooth muscle relaxation.
5mg can cause severe heartburn/new acid reflux—may enhance poor stomach state (e.g., high-carb diet).
Sildenafil (Viagra) rarely prescribed; shorter half-life vs. tadalafil's sustained daily effect—not for chronic arterial use.
Specific: pulmonary arterial hypertension (high pressure in pulmonary artery carrying deoxygenated blood from heart to lungs). Overloads heart if narrowed.
Restricted blood flow overloads the heart, causing right-sided heart failure. PDE5 inhibitors like Cialis could help in these cases, even for women.
Research on using these drugs for lower urinary tract symptoms (LUTS) or improving sexual function in women shows little evidence—some trials exist, but it's not widely discussed. It doesn't seem to work the same for women as for men. Women lack a prostate, so LUTS from prostate enlargement doesn't apply, and other drugs are used for bladder symptoms.
The lower bladder can get blocked similarly to prostate growth, with tight muscles causing blockage. Theoretically, PDE5 inhibitors could help, but no evidence supports it. Research signals are not positive, so neurologists don't pursue it.
Consider becoming a member for easier question answering. Let us know in comments if you like this format. Previously, we jawboned without addressing questions at the end; now answering as they come in, related to the topic.
Target blood pressure below 120/80—not just per guidelines, but to detect changes early for lifestyle interventions.
If blood pressure is 90/60 or lower, assess why. Very thin people might have 80/50 and feel fine, but building muscle should raise it. Not ideal to see below 90/60 often.
Low blood pressure in 50s-60s risks dizziness, stroke, heart attack because older arteries aren't supple enough to constrict properly, unlike in 20-year-olds.
Gym work, resistance training, and isometrics help lower numbers. No age-based variations in targets.
10mg tadalafil daily is too much.
Prep Medel helps CABG patients.
Phone number at end for becoming a patient.
Watch previous video from last Saturday: Visit to Hobie (as wife Susanna calls him), who has heart failure and motivation issues. He's improving. Part of push series where Dr. Brewer travels the US helping fix chronic conditions. Couple episodes recorded and editing; two already available on channel.
Easter egg: Took daily Cialis pill on stream.
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Everyone knows it's not for sissies, but it's a heck of a lot better with good arteries.
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