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doi: 10.12688/f1000research.20510.1

Dependency Concerns: Some individuals may develop a psychological dependency on Viagra, relying on it for sexual performance, which can lead to anxiety or stress without it

They include changes in the production of constricting and relaxing factors endothelium-derived, interruption of molecular signaling, increased oxidative stress, renal injury, insulin resistance, hyperinsulinemia, sleep apnea syndrome, that make hemodynamic alterations (108, 109)