Could Blood Pressure Meds Help Prevent Adult Epilepsy?

2024-06-20

临床结果

THURSDAY, June 20, 2024 -- A class of blood pressure medications appears to also help lower seniors’ risk of developing epilepsy, a new study finds.

The drugs, called angiotensin receptor blockers (ARBs), might prevent epilepsy in people at highest risk of the disease, researchers reported June 17 in the journal JAMA Neurology.

“This is incredibly exciting because we don’t currently have any medicines that prevent epilepsy,” said senior researcher Dr. Kimford Meador, a professor of neurology at Stanford University School of Medicine. “I hope these initial findings lead to randomized clinical trials.”

Epilepsy is most often diagnosed during childhood, but more than 1% of people older than 65 are known to develop the recurring seizures associated with the brain disorder.

Stroke is the most common risk factor for developing epilepsy as a senior. About 10% of stroke survivors develop seizures within five years, researchers noted.

Hardened arteries and chronic high blood pressure also boost epilepsy risk, whether or not a person has had a stroke, the researchers added.

“This can be a very debilitating disorder, and it’s much more common in older adults than people realize,” Meador said in a Stanford news release.

A 2022 study of more than 160,000 people in Germany found that people taking ARBs for high blood pressure had a lower risk of epilepsy, researchers said.

Those drugs block receptors for angiotensin II, a protein that causes blood vessels to narrow, which increases blood pressure. The drugs also decrease inflammation in blood vessels and other organs, including the brain.

“Those results out of Germany echoed what had been found in animal studies and seemed very promising, but I felt that it was important to reproduce that analysis using data on people in the U.S.,” Meador explained.

For the new study, researchers analyzed data on 2.2 million adults diagnosed with high blood pressure who had been prescribed at least one blood pressure med. None of the people had epilepsy at the start of the study.

About 14% of the people taking a blood pressure medication had been prescribed an ARB, researchers said.

Overall, people taking ARBs had a 20% to 30% lower risk of developing epilepsy between 2010 and 2017, compared with people taking other blood pressure meds.

This held true even when people with strokes were removed from the analysis, researchers noted. That suggests that the lower rates of epilepsy were not because the ARBs reduced people’s risk of stroke.

“What we’ve done is replicate what was found in Germany, but in a larger and completely different population,” Meador said. “That really increases the strength of the signal and tells us that there’s something real going on here.”

One particular ARB, losartan (Cozaar), had the most powerful effect on epilepsy risk. However, researchers said more study is needed to confirm that finding.

All blood pressure meds can reduce epilepsy risk because high blood pressure contributes to epilepsy, the researchers noted.

But these findings suggest that ARBs might be potentially more beneficial than other blood pressure drugs.

“This could be a new chapter in the story of preventive medicine,” Meador said. “There are so many people with stroke or high blood pressure; knowing that this class of drug not only lowers blood pressure but also helps lower their epilepsy risk could change how we treat them.”

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