JAMA NEUROLOGY: ARB DRUGS NOT ONLY REDUCE HYPERTENSIVE DISORDERS, BUT ALSO SIGNIFICANTLY REDUCE THE INCIDENCE OF EPILEPSY

Arterial hypertension is associated
with an increased incidence of epilepsy.
The results of animal studies suggest that angiotensin receptor blocker (ARB) treatment can suppress seizures
.
However, there is a lack of clinical data to support the use
of ARB therapy in humans.
The aim of the study was to assess whether ARB treatment was associated
with a decrease in the incidence of epilepsy in people with hypertension.

This cohort study obtained data
from the Disease Analyzer Database (IQVIA) in hypertensive patients aged 18 years or older and at least one prescription for antihypertensive drugs.
Between January 2010 and December 2020, patients were treated
in 1,274 general clinics in Germany.
There are data
on 1553875 patients who have been prescribed at least 1 antihypertensive drug.
Patients treated with class 1 of the four antihypertensive drugs (β-blockers BBB, ARBs, ACE, ACE, and calcium-channel blockers [CCBs]) were matched
using propensity scores.
The primary outcome was the incidence of
epilepsy associated with ARB treatment compared to other antihypertensive drug classes.

Results A total of 168612 patients were included in the propensity score match, with 42,153 patients in each antihypertensive drug class
.
The mean age of patients [SD] was 62.
3 [13.
5] years, and 21 667 (51.
4%) were women
.
The incidence of epilepsy within 5 years was lowest in patients receiving ARB therapy (0.
27% at 1 year, 0.
63% at 3 years, 0.
99% at 5 years) and highest in patients receiving BBB and CCB (0.
38% at 1 year - both β-blockers and CCB); At 3 years, β-blockers were 0.
91% and CCB 0.
93%; β-blockers are 1.
47%; CCB was 1.
48% at 5 years).

Treatment with ARBs was associated with a significant 23% reduction in epilepsy incidence compared to other drug classes (HR = 0.
77; 95% CI, 0.
65 to 0.
90).

In this cohort study of hypertensive patients, ARB treatment was associated
with a significantly lower incidence of epilepsy.
The findings suggest that antihypertensive drugs can be used as a new way to
prevent epilepsy in patients with arterial hypertension.

References:

Association Between Angiotensin Receptor Blocker Therapy and Incidence of Epilepsy in Patients With Hypertension.
JAMA Neurol.
Published online October 17, 2022.
doi:10.
1001/jamaneurol.
2022.
3413