Heart drugs show promise in stroke and dementia

pharmafile | April 25, 2019 | News story | Research and Development angina, cilostazol, dementia, heart drugs, isosorbide mononitrate, stroke 

Drugs for heart disease and angina have shown promise as preventative treatments for stroke and dementia, according to scientists from the University of Edinburgh.

Damage to small blood vessels in the brain is responsible for around a quarter of strokes while also being a common cause of memory problems and dementia.

Cilostazol and isosorbide mononitrate work by relaxing smooth muscle cells in blood vessels and thus inducing a vasodilatory effect.

The two heart drugs were thus trialled in patients who had experienced strokes that had been caused by damage to small blood vessels (lacunar strokes)

While cilostazol and isosorbide mononitrate are often used to treat certain heart conditions, the study, published in the journal EClinicalMedicine, marks the first time these drugs have been as a treatment for stroke or vascular dementia in the UK.

Although the drugs had shown promise as treatments for stroke and dementia in studies conducted in the Asia-Pacific countries on Asian populations, there was a lack of data concerning western populations.

The study showed that cilostazol and isosorbide mononitrate were well tolerated in patients with lacunar stroke.

There were also signs that the drugs helped to improve blood vessel function in the brain and arms and that the drugs may also improve thinking skills.

The trial of 57 patients found patients who took cilostazol took less time to complete questionnaires than patients who had not taken the drug. The findings pave the way for future studies into the effectiveness of these drugs in preventing stroke and dementia.#

Lead researcher Professor Joanna Wardlaw, of the University of Edinburgh’s Centre for Clinical Brain Sciences, said: “We are delighted that the results of this trial show promise for treating a common cause of stroke and the commonest cause of vascular dementia, since currently there are no effective treatments. Further trials are underway.”

While cilostazol costs the NHS around £5 a month isosorbide mononitrate costs the NHS just £1 a month. As such, the drugs may offer an affordable means of preventing stroke and dementia in some patients.

Dr James Pickett, Head of Research at Alzheimer’s Society, added: “There hasn’t been a new drug for dementia for 15 years, so finding evidence that these cheap existing drugs could prevent dementia after a stroke would be a huge breakthrough. It’s promising to see that these two drugs are safe to use and we’ll be excited to see the results of the next stage of testing in a couple of years, which will show whether these drugs can be an effective treatment.”

Louis Goss

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