Sildenafil [‘Viagra’] may have a role in the treatment of heart failure and hypertension, according to data presented at the 3rd Annual Scientific Meeting of the Heart Failure Society of America [San Francisco, US; September 1999]. In one trial, sildenafil improved brachial artery vasodilation compared with placebo after arterial occlusion in patients with heart failure. In the second trial, sildenafil augmented and prolonged the effects of inhaled nitric oxide in patients with chronic pulmonary hypertension and heart failure. Additionally, sildenafil proved to be a balanced vasodilator, improving pulmonary vasodilation and reducing systemic vascular resistance.