Can commonly prescribed heart medication treat vascular dementia?

Lead Investigator: Professor Philip Bath

Institution: University of Nottingham

Grant type: Project grant

Start date: 01/07/2025

Duration: 36 months

Amount: £397,384.00

Project summary

After a stroke some people can develop disease of the small blood vessels in their brains. This can cause vascular dementia to develop and sadly there is currently no cure or treatment.

Professor Philip Bath and the research team will run a clinical trial to understand whether test two drugs (that are already used for other diseases) can improve blood flow to the brain in people with small vessel disease. This is important, as reduced blood flow can starve the brain of nutrients, and cause damage to brain cells and ultimately, vascular dementia.

Through this research Professor Bath will gather enough evidence to run larger trials to introduce these drugs into clinical practice, reducing the risk of developing dementia after stroke.

Project background

Small vessel disease can happen after a stroke, damaging the blood vessels in the brain and reducing blood flow. This can cause vascular dementia. Despite being a major concern for many people affected by stroke, there is currently no treatment or cure for small vessel disease. 
Professor Bath and the team identified two drugs which are currently used for other diseases, which could be used in improving blood flow to the brain in people with small vessel disease.

The first drug is called isosorbide mononitrate and is commonly used in the UK to treat heart disease and angina. The second drug is called cilostazol and is used to treat hardening of the arteries in the legs in the UK and for preventing stroke in East Asia. These drugs are inexpensive, easy to take, usually have minor side effects, and doctors in the UK are already used to prescribing them.

If this small trial is successful, the team will carry out larger trials to investigate both drugs, so that they can be available as treatment for dementia after stroke in the UK.

What does this project involve?

The researchers will contact 400 eligible participants (people who have had a stroke) from 25 UK hospitals to talk about the study. People who are interested will be invited to take part. The research team will randomly allocate them into groups. These groups of people will receive either: drug, both drugs, or no drug, to investigate their effects.

Dedicated research nurses will support all participants throughout the study, and the researchers will follow participants for 6 months to gather enough evidence to understand whether the drugs are both safe and effective in improving memory and thinking, and whether it is possible to run larger trials in the future. If these larger trials are successful, this could allow these drugs to be licensed as a treatment for dementia after a stroke.

How will this project help people with dementia?

If successful, this project could support the first ever treatments for small vessel disease and vascular dementia in the UK. This offers new hope for thousands of people and families currently affected by the disease.