Angiotensin receptor blocker therapy associated with decreased incidence of epilepsy

October 18, 2022

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Researchers have reported in JAMA Neurology.

High blood pressure is associated with an increased incidence of epilepsy, but recent study results suggest that treatment with angiotensin receptor blockers (ARBs) may inhibit epileptic seizures, Corinna Doege, MD, from the Department of Pediatric Neurology at Bremen Central Hospital in Germany, and colleagues reported.

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Doege and colleagues sought to assess whether ARB treatment was associated with a decreased incidence of epilepsy in adults with hypertension.

The researchers obtained data from the Disease Analyzer database on patients aged 18 and older with high blood pressure who had at least one prescription for antihypertensive medication. Of more than 1.5 million patients for whom data are available, 168,612 were included in the study (51.4% women; mean age, 62.3 years).

Patients treated with one of four antihypertensive drugs – ARBs, beta-blockers, angiotensin-converting enzyme inhibitors and calcium channel blockers – were matched using propensity scores, with 42,153 patients in each class of drugs. The researchers compared the incidence of epilepsy associated with ARA therapy with the other drugs.

Over 5 years, the incidence of epilepsy was lowest in those treated with ARBs (0.27% at 1 year; 0.63% at 3 years; 0.99% at 5 years) and highest among those receiving beta-blockers (0.38%, 0.91% and 1.47%). %, respectively) and calcium channel blockers (0.38%, 0.93% and 1.48%, respectively).

Compared to other drug classes, treatment with ARBs was associated with a significant decrease in the incidence of epilepsy (HR=0.77; 95% CI, 0.65-0.9).

“The results suggest that antihypertensive drugs could be used as a novel approach to prevent epilepsy in patients with high blood pressure,” the authors wrote.

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