A groundbreaking study by the University of Oxford has revealed that sildenafil, commonly known as Viagra, can enhance blood flow to the brain and improve the function of brain blood vessels in people at high risk of vascular dementia.
This study, published in Circulation Research, could mark a significant advancement in the fight against this debilitating condition.
Dr. Alastair Webb, an Associate Professor at the Wolfson Center for Prevention of Stroke and Dementia at Oxford University, explained, “This is the first trial to show that sildenafil gets into the blood vessels in the brain of people with this condition, improving blood flow and how responsive these blood vessels are.
These two factors are associated with chronic damage to the small blood vessels in the brain, which is the most common cause of vascular dementia.
This demonstrates the potential of this well-tolerated, widely-available drug to prevent dementia, which needs testing in larger trials.”
The importance of this research lies in its potential to change how we treat and prevent vascular dementia, which currently lacks specific therapies.
Chronic damage to the small blood vessels in the brain is not only the leading cause of vascular dementia but also contributes to 30% of strokes and 80% of brain bleeds.
High blood pressure, reduced blood flow to the brain, and impaired blood vessel function worsen these conditions, making this study’s findings particularly significant.
The OxHARP trial was a carefully designed double-blind, placebo-controlled study involving 75 participants who had experienced a minor stroke and showed signs of mild to moderate small vessel disease.
Each participant received sildenafil, a placebo, and cilostazol (a similar drug) over three-week periods in a randomized order. The study used cardiovascular physiology tests, ultrasound, and functional MRI scans to evaluate the drugs’ effects.
Key findings from the study include:
- Sildenafil increased blood flow in both large and small brain vessels, as measured by ultrasound and MRI scans.
- Sildenafil improved the blood flow response to carbon dioxide, indicating better cerebrovascular function.
- Both sildenafil and cilostazol reduced blood vessel resistance in the brain.
- Sildenafil caused fewer side effects compared to cilostazol, particularly with less incidence of diarrhea.
Looking ahead, larger-scale trials are needed to confirm these findings and explore sildenafil’s potential in preventing vascular dementia on a broader scale.
Professor Peter Rothwell, Founding Director of the Wolfson Center for Prevention of Stroke and Dementia, remarked, “Professor Webb’s findings are very encouraging and highlight the potential for preventing vascular dementia using existing drugs that target the underlying reduction in flow in the small blood vessels in the brain.”
This study opens up new possibilities for using an existing, widely-available drug to combat a condition that currently has no specific treatment, potentially improving the lives of many people at risk of vascular dementia.
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