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Sexual intercourse may increase the risk of having cardiovascular disease especially among patients who have the history of experiencing some. So, treatments for impotency like Cialis, is not advised for men or patients which have cardiac disorders.Physicians should consider the possible cardiac risks posed by sexual intercourse on patients which are already experiencing cardivascular diseases.Patients who experience symptoms upon initiation of sexual activity should be advised to refrain from further sexual activity and seek immediate medical attention. There have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for this class of compounds. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. Patients who have an erection lasting greater than 4 hours, whether painful or not, should seek emergency medical attention. Proper medical assessment should be taken account in the evaluation of impotency. The physician should also consider the potential causes and the recognition of appropiate methods to treat impotency. There are no clinical studies which can support the safety and efficacy of Cilialis (Tadalafil) with other drugs used to treat impotency or erectile dysfunction among men. As with other PDE5 inhibitors, tadalafil has mild systemic vasodilatory properties that may result in transient decreases in blood pressure. In a clinical pharmacology study, tadalafil 20 mg resulted in a mean maximal decrease in supine blood pressure, relative to placebo, of 1.6/0.8 mm Hg in healthy subjects. While this effect should not be of consequence in most patients, prior to prescribing CIALIS, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects. Patients with severely impaired autonomic control of blood pressure may be particularly sensitive to the actions of vasodilators, including PDE5 inhibitors.