This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Cardiovascular disease is a major cause of morbidity and mortality in patients with diabetes. Endothelial dysfunction has been implicated in the artherogenic process and is present in patients with diabetes much before overt evidence of atherosclerosis. Erectile dysfunction manifests as decreased Flow Mediated Dilatation (FMD), which is a functional abnormality, and abnormal circulating markers which are biochemical abnormalities. Recent data has shown that endothelial dysfunction was improved by sildenafil in heart failure patients. We have preliminary data that indicates improvement of endothelial function in patients with type 2 diabetes. Our hypothesis is that daily treatment with sildenafil will improve biochemical markers of important non-traditional risk factors of cardiovascular disease and thus may play an important role in the prevention and modulation of cardiovascular disease in patients with diabetes. We propose to confirm our hypothesis by pursuing the following specific aim: determine the effect of chronic sildenafil treatment on biochemical markers of endothelial dysfunction (inflammation, oxidative stress) in patients with diabetes.
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