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How long is viagra effective? VIAGRA usually starts to work within 30-60 minutes. You may take it up to 4 hours before sexual activity. So there's no need to rush. Can you take Viagra if you have heart disease? Sildenafil has two actions that may be of consequence in patients with heart disease. First, it can lower the blood pressure. Patients taking both nitrates and sildenafil are prone to develop severe hypotension (Patients taking nitrates for their coronary artery disease, therefore, should never take sildenafil. What is the first line treatment for hypertension? Initial first-line therapy for stage 1 hypertension includes thiazide diuretics, CCBs, and ACE inhibitors or ARBs. Two first-line drugs of different classes are recommended with stage 2 hypertension and average BP of 20/10 mm Hg above the BP target.
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