Genetically proxied PDE5 inhibition was associated with 16% lower odds of erectile dysfunction (OR 0.84, 95% CI 0.78–0.89, p < 0.001) and 22% lower odds of pulmonary arterial hypertension (OR 0.78, 95% CI 0.67–0.90, p < 0.001) per SD lower in diastolic blood pressure. This evidence concerns the gene PDE5A and pulmonary arterial hypertension.