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Viagra Shows Promise in Reducing Vascular Dementia Risk

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Viagra, first designed to treat angina, rose to fame in the late 1990s as an effective treatment for erectile dysfunction. Because it is a relatively safe drug and affects several organs, such as the heart, liver, kidney, and brain, it is a good candidate for drug repurposing. For instance, scientists have already investigated whether sildenafil might help treat conditions including chronic pain, cancer, depression, kidney disease, and more. The latest study asks whether Viagra might help reduce the risk of developing vascular dementia.It often occurs after a stroke. As the second most common form of dementia after Alzheimer’s disease, vascular dementia accounts for 15–20% of dementia cases in North America and Europe. 

Some doctors say that there are treatments available that can help manage the symptoms and slow the progression of the disease. However, there is no cure, so identifying risk factors and ways to reduce those risks is important. 

Cerebral small vessel disease (CSVD) is one such risk factor. CSVD is an umbrella term for a number of conditions that affect small blood vessels in the brain.

Small vessel disease is chronic damage to the small blood vessels deep inside the brain, resulting in them becoming narrow, blocked, and leaky. This damage occurs to some extent in most people as they get older, but it is much more severe in some, often due to having high blood pressure for a long time. The resulting damage may further reduce blood flow to the deep part of the brain resulting in strokes and dementia. In the recent study, the scientists recruited 75 people with neurological signs of CSVD. 

Every participant received 3-week regimens of sildenafil, placebo, and cilostazol — a treatment for vascular disease. Each course of drugs was separated by a “washout” period of at least 1 week. 

Testing all three drugs on all participants is called a crossover trial. These studies are powerful because each participant acts as their own control. They also require fewer participants to achieve statistically meaningful results. 

The researchers found that sildenafil did not improve cerebral pulpability compared with placebo. Although Webb “had reason to believe that it would reduce pulsations,” the team was not overly surprised that it did not work in this way. Importantly, though, sildenafil did improve cerebrovascular reactivity and resistance, and cerebral blood flow compared with placebo. Compared with cilostazol, Viagra performed similarly but produced fewer side effects, such as diarrhea.

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