Angiotensin receptor blocker therapy associated with decreased incidence of epilepsy

Patients with hypertension who received angiotensin receptor blocking therapy had a significant decrease in incidence of epilepsy, researchers reported in JAMA Neurology.

Arterial hypertension is associated with an increased incidence of epilepsy, but results from recent studies suggest angiotensin receptor blocker (ARB) therapy could inhibit epileptic seizures, Corinna Doege, MD, of the department of pediatric neurology at Central Hospital Bremen in Germany, and colleagues reported.

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

Researchers obtained data from the Disease Analyzer database on patients aged 18 years and older who had hypertension and at least one antihypertensive drug prescription. Of more than 1.5 million patients with available data, 168,612 were included in the study (51.4% women; mean age, 62.3 years).

Patients treated with one of four antihypertension drugs — ARBs, beta-blockers, angiotensin-converting enzyme inhibitors and calcium channel blockers — were matched to one another using propensity scores, with 42,153 patients in each drug class. Researchers compared the incidence of epilepsy associated with ARB therapy with the other drugs.

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

Compared with the other drug classes, treatment with ARB therapy was associated with a significantly decreased incidence of epilepsy (HR = 0.77; 95% CI, 0.65-0.9).

“The findings suggest antihypertensive drugs could be used as a novel approach for preventing epilepsy in patients with arterial hypertension,” the authors wrote.