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A new study reveals that sildenafil, commonly sold as Viagra, enhances brain blood flow and improves blood vessel function in patients at risk of vascular dementia.

Viagra and Vascular Dementia

The University of Oxford conducted a trial that demonstrates Viagra's potential to address vascular dementia, a condition characterized by chronic damage to the brain's small blood vessels. This study, published in Circulation Research, marks a significant advancement in understanding and potentially treating this debilitating condition.

The OxHARP trial, a double-blind, placebo-controlled study, involved 75 participants who had experienced minor strokes and exhibited signs of mild to moderate small vessel disease. The trial tested sildenafil alongside cilostazol, another similar drug, and a placebo. Each participant received all three treatments in a randomized order over three-week periods.

The research team utilized various methods, including cardiovascular physiology tests, ultrasound, and functional MRI scans, to evaluate the drugs' effects on brain blood flow and vessel function.

Key Findings

The study found that Viagra or sildenafil increased blood flow in both large and small brain vessels. This was measured using ultrasound and MRI scans, which showed improved blood flow responses to carbon dioxide. This indicates enhanced cerebrovascular function. Sildenafil also reduced blood vessel resistance in the brain and caused fewer side effects compared to cilostazol, particularly with a lower incidence of diarrhea.

Dr. Alastair Webb, an Associate Professor at Oxford University's Wolfson Center for Prevention of Stroke and Dementia, highlighted that this trial is pioneering in demonstrating sildenafil's ability to enter brain blood vessels, enhancing both blood flow and vessel reactivity. These improvements are crucial as they address chronic damage to small brain vessels, the most common cause of vascular dementia.

Significance

The findings are promising for the future of vascular dementia treatment. Chronic damage to small brain vessels not only leads to vascular dementia but also contributes to 30% of strokes and 80% of brain bleeds. The potential of sildenafil to improve blood flow and reduce vessel resistance could make it a valuable tool in preventing these conditions.

Future Directions

The next steps involve conducting larger-scale trials to confirm these initial findings and further explore sildenafil's potential in preventing vascular dementia. Professor Peter Rothwell, Founding Director of the Wolfson Center for Prevention of Stroke and Dementia, remarked that these results are encouraging and highlight the possibility of using existing drugs to target and prevent the underlying causes of vascular dementia.