Vascular Dementia: Sildenafil Improves Blood Flow

In patients at risk of vascular dementia, sildenafil (Viagra) improves blood vessel function and increases cerebral blood flow, according to a recent study. An important step forward in treating this illness is represented by this work.

The researchers discovered that sildenafil improved blood flow in both small and large cerebral arteries, perhaps averting dementia. These results demonstrate the drug’s potential for larger-scale studies to validate its efficacy.

Important Details:

1. In patients who were at risk, sildenafil enhanced cerebrovascular function and blood flow.

2. 75 people with mild stroke and small vessel disease were enrolled in the trial.

3. Comparing sildenafil to another comparable medication that was evaluated, there were fewer adverse effects. 

Oxford University is the source.

According to a recent experiment by the University of Oxford, sildenafil, better known by the brand name Viagra, increases cerebral blood vessel function and blood flow in people who are more susceptible to vascular dementia.

The publication of this study in Circulation Research could be a turning point in the battle against this crippling illness.

“This is the first trial to show that sildenafil gets into the blood vessels in the brain in people with this condition, improving blood flow and how responsive these blood vessels are,” stated Dr. Alastair Webb, an associate professor at Oxford University’s Wolfson Center for Prevention of Stroke and Dementia.

“These two key factors are associated with chronic damage to the small blood vessels in the brain, which is the commonest cause of vascular dementia. This demonstrates the potential of this well-tolerated, widely-available drug to prevent dementia, which needs testing in larger trials.”

This research is significant because it has the potential to revolutionize the prevention and treatment of vascular dementia, for which there are now no effective treatments.

Not only is chronic brain damage to the brain’s small blood arteries the primary cause of vascular dementia, but it also plays a role in 30% of strokes and 80% of brain bleeds. The results of this experiment are especially important because high blood pressure, decreased blood flow to the brain, and altered blood vessel function exacerbate these diseases.

A carefully planned double-blind, placebo-controlled trial called OxHARP involved seventy-five people who had suffered a mild stroke and had mild to moderate small vessel disease.

Over three weeks, each individual was randomly assigned to receive sildenafil, a placebo, and cilostazol, a comparable medication. The study used functional MRI scans, ultrasonography, and tests of cardiovascular physiology to assess the effects of the medications.

Important conclusions consist of:

According to results from MRI and ultrasound examinations, sildenafil improved blood flow in both major and small brain arteries.

The blood flow response to carbon dioxide was amplified by sildenafil, suggesting better cerebrovascular health.

In the brain, cilostazol and sildenafil both reduce blood vessel resistance.

When compared to cilostazol, sildenafil produced fewer side effects, especially diarrhea.

Larger-scale trials are needed to validate these results and investigate sildenafil’s ability to prevent vascular dementia more broadly in the future.

The founding director of the Wolfson Center for Prevention of Stroke and Dementia, Professor Peter Rothwell, stated, “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.”

For more information: Cerebrovascular Effects of Sildenafil in Small Vessel Disease: The OxHARP Trial, Circulation Research, https://doi.org/10.1161/CIRCRESAHA.124.324327