Angiotensin Receptor Blocker Use Linked to Lower Incidence of Epilepsy

2024-06-21

临床结果

FRIDAY, June 21, 2024 -- For patients with hypertension, angiotensin receptor blockers (ARBs) are associated with a reduced incidence of epilepsy compared with other antihypertensive medications, according to a study published online June 17 in JAMA Neurology.

Xuerong Wen, Ph.D., from the University of Rhode Island in Kingston, and colleagues conducted a retrospective cohort study to examine the association between ARB use and epilepsy incidence in subgroups of U.S. patients with hypertension. Patients who received ARBs were propensity score (PS)-matched to those who received angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, calcium channel blockers (CCBs), or a combination of these medications. Of the participants, 309,978 received ARBs, 807,510 received ACEIs ACEIs, 695,887 received β-blockers, and 448,589 received CCBs; the 1:1 PS-matched subgroups included 619,858 patients for ARB versus ACEI, 619,828 patients for ARB versus β-blocker, and 601,002 patients for ARB versus CCB.

The researchers found that the incidence of epilepsy was reduced with use of ARBs versus ACEs, β-blockers, and a combination of other antihypertensive classes (adjusted hazard ratios, 0.75, 0.70, and 0.72, respectively). In subgroup analyses, the investigators observed a significant association between ARB use (mainly losartan) and epilepsy incidence in patients with no preexisting history of stroke or cardiovascular disease.

"Further pharmacological studies, including randomized clinical trials, are needed to establish antiepileptogenic properties of antihypertensive medications," the authors write.

Two authors disclosed ties to the pharmaceutical and medical device industries.

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