Blood pressure drugs might prevent epilepsy: Exciting new research

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A new study suggests that a type of blood pressure medication, called angiotensin receptor blockers, could help prevent epilepsy in adults.

This finding comes from an analysis of medical records from over 2 million Americans and was published on June 17 in JAMA Neurology.

Epilepsy often starts in childhood, but more than 1% of people over age 65 are diagnosed with it. These recurring seizures can temporarily disrupt brain function and cause various symptoms.

For older adults, the most common risk factor for developing epilepsy is stroke. About 10% of stroke survivors experience seizures within five years.

Chronic high blood pressure and vascular disease also increase the risk of epilepsy.

“We currently have no medicines that can prevent epilepsy,” said Dr. Kimford Meador, a neurology professor and senior author of the study. “This finding is very exciting and could lead to new treatments.”

Previous studies suggested that angiotensin receptor blockers might help prevent seizures by reducing inflammation. This is especially relevant for seizures following strokes or brain injuries, as both can cause brain inflammation that may lead to epilepsy.

In 2022, a study of over 160,000 people in Germany found that those taking these blood pressure drugs had a lower risk of developing epilepsy.

Dr. Meador wanted to see if this finding held true for people in the U.S. He and his team used a national database with health care claims from over 20 million Americans. They focused on 2.2 million adults who had high blood pressure, were taking at least one blood pressure medication, and did not already have epilepsy.

The study found that people taking angiotensin receptor blockers had a 20% to 30% lower risk of developing epilepsy between 2010 and 2017 compared to those taking other blood pressure medications. This finding remained even when patients who had strokes were excluded from the analysis, suggesting that the reduced epilepsy risk was not just due to a lower risk of stroke.

“What we’ve done is replicate the findings from Germany with a larger and more diverse population,” Meador said. “This strengthens the evidence that there is something real happening here.”

The data also indicated that one specific drug, losartan, had the most significant effect on lowering epilepsy risk. However, more research is needed to confirm this.

All blood pressure medications may help reduce epilepsy risk since high blood pressure is a known factor for the condition. Keeping blood pressure under control with any combination of drugs and lifestyle changes can lower the chance of developing epilepsy. However, this research suggests that angiotensin receptor blockers might be especially beneficial.

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

However, Meador added, randomized clinical trials are needed to prove the link between angiotensin receptor blockers and reduced epilepsy risk before treatment guidelines can change.

Researchers from Brown University also contributed to the study.

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