JAMA Study Finds Existing Blood Pressure Drugs May Prevent Epilepsy

Stanford Medicine researchers and their colleagues have discovered that a class of drugs already on the market to lower blood pressure appears to reduce adults’ risk of developing epilepsy.

The study, published in JAMA Neurology, suggested that the drugs, called angiotensin receptor blockers, could prevent epilepsy in people at highest risk of the disease, including older adults who have had strokes.

Epilepsy, often diagnosed in childhood, also affects over 1% of people over 65, with seizures disrupting brain function and causing various symptoms. In older adults, stroke is the leading risk factor for epilepsy, with 10% of stroke survivors experiencing seizures within five years. Vascular disease and chronic high blood pressure further increase the risk.

While anti-seizure medications control epilepsy after diagnosis, no drugs currently prevent it in high-risk individuals. Recent studies, however, suggest that certain blood pressure medications might help prevent seizures by reducing inflammation, particularly in cases following stroke or traumatic brain injuries, which can trigger epilepsy.

In the study, researchers analysed data from 2.2 million adults diagnosed with high blood pressure who were prescribed at least one blood pressure medication and did not have epilepsy.

They found that individuals taking angiotensin receptor blockers had a 20% to 30% lower risk of developing epilepsy compared to those taking other blood pressure drugs. This reduced risk remained even when patients with strokes were excluded from the analysis, indicating that the lower epilepsy rates were not solely due to a decreased risk of stroke.

“All blood pressure medications likely reduce the risk of epilepsy since high blood pressure contributes to the disorder. Controlling blood pressure through medication and lifestyle changes can lower epilepsy risk. However, new research suggests that angiotensin receptor blockers might be more effective than other antihypertensives in reducing this risk. In the study, 14% of participants took angiotensin receptor blockers, while the majority used other blood pressure medications such as beta blockers, calcium channel blockers, and ACE inhibitors,” said the authors.

Reference: Wen X, Otoo MN, Tang J, et al. Angiotensin Receptor Blockers for Hypertension and Risk of Epilepsy. JAMA Neurol. Published online June 17, 2024. doi:10.1001/jamaneurol.2024.1714