Imaging research suggests Viagra could slow or prevent vascular dementia

A medication used to treat erectile dysfunction could also improve blood flow, and thus blood vessel function, in the brain in individuals vulnerable to vascular dementia. 

New research out of the University of Oxford suggests sildenafil, known by its brand name Viagra, can improve cerebrovascular function and minimize the risk of cognitive impairment caused by small vessel disease. MRI and transcranial ultrasound exams revealed sildenafil to be more effective than similar medications at increasing blood flow in blood vessels throughout the brains of people who had previously suffered a stroke. 

Experts involved in the research say their results could lead to improved treatment methods targeted at vascular dementia. 

“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,” Alastair Webb, an Associate Professor at the Wolfson Center for Prevention of Stroke and Dementia at the University of Oxford said. “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.” 

The OxHARP (Oxford Hemodynamic Adaptation to Reduce Pulsatility) trial included 75 patients who had previously suffered a minor stroke and displayed white matter hyperintensities on imaging. Participants were divided into three groups—one treated with sildenafil, one with cilostazol (a similar drug commonly used to treat peripheral artery disease) and one that was given a placebo.  

Following three weeks of treatment, participants underwent a slew of cardiovascular exams, including transcranial ultrasound and blood oxygen-level dependent MRI. On imaging, sildenafil increased blood flow in both large and small blood vessels and improved blood flow response to carbon dioxide, while both medications improved blood flow resistance. 

Both drugs triggered headaches, but sildenafil was more frequently well tolerated and did not cause as many side effects. 

Experts involved in the work encourage more research among larger groups of patients to determine whether sildenafil could be a truly feasible option for slowing or preventing small vessel disease.  

The study abstract is available here

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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