Two common drugs could be used to minimise side-effects of stroke linked to dementia, study finds

Wednesday, 24 May 2023

Two common and cheap drugs could be used to treat a type of stroke that affects at least 35,000 people in the UK each year, a new study shows. 

Researchers from the University of Edinburgh and the University of Nottingham led a trial, funded by the British Heart Foundation, to explore how the drugs could improve the side effects seen after a lacunar stroke.

The two drugs, isosorbide mononitrate and cilostazol, are already used to treat other heart and circulatory diseases. Often used together, the drugs could be made available as treatment for lacunar strokes within five years, if positive results are found in further studies.

The drugs investigated are believed to improve the function of the inner lining of blood vessels, which researchers believe play a role in cerebral small vessel disease (cSVD) – commonly a cause of dementia and cognitive impairment, but with no specific treatment.

"These are vitally important results and need to be confirmed in larger trials, not just after lacunar stroke but also in other forms of stroke and small vessel disease. The results also support the belief that small vessel disease is due to problems with the lining of blood vessels and treating that may help reverse that abnormality.”
Philip Bath, Professor of Stroke Medicine at the University of Nottingham

363 people took part in the ground-breaking new study, taking either drug individually, both drugs together, or neither of the drugs being tested.

Participants that took both drugs were nearly 20 per cent less likely to have problems with their thinking and memory compared to the group that did not take either drug. Stroke sufferers were also found to be more independent and reported a better quality of life.

"Now we understand more about what is triggering these small vessel strokes to attack the brain, we’ve been able to focus our efforts on treatments that can put a halt to this damage."
Professor Joanna Wardlaw, Chair of Applied Neuroimaging at the University of Edinburgh and Foundation Chair at the UK Dementia Research Institute

She added: "We need to confirm these results in larger trials before either drug can be recommended as a treatment. However, as these drugs are already widely available for other circulatory disorders, and inexpensive, it shouldn’t take too long to move our findings from research into everyday clinical practice.”

Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said: “These promising findings provide a long-awaited positive step towards the first treatments becoming available for lacunar strokes, offering much needed hope for thousands of people.

"Lacunar strokes are not the only way that cerebral small vessel disease can affect someone. These findings also open new avenues of research into other conditions related to small vessel disease, such as vascular dementia.”

Story credits

More information available from Professor Phillip Bath in the School of Medicine at

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