Antihypertension Drugs May Reduce Risk of Poststroke Epilepsy

The use of angiotensin receptor blockers (ARBs) may lower the risk of poststroke epilepsy (PSE) in individuals with hypertension and ischemic stroke, according to study results presented at the American Epilepsy Society (AES) 2024 Annual Meeting. Stroke is the most common cause of seizures in individuals aged >60 years, and hypertension is a risk factor for epilepsy and stroke.

The retrospective, observational study included 528 individuals with hypertension and an ischemic stroke diagnosis as confirmed by clinical and neuroimaging evaluation. Researchers reviewed antihypertensive treatments, demographics, and clinical and neuroradiological data associated with study participants. PSE diagnosis was made according to International League Against Epilepsy (ILAE) criteria. Researchers followed up with participants for an average of 66 months.

• 7.2% of patients (n=38) developed PSE during the follow-up period
• Patients treated with ARBs showed a lower risk of developing PSE (P=.009)
• Higher PSE incidence was observed in patients receiving calcium channel blockers (CCBs) (P=.019) and beta-blockers (P=.008)
• Individuals who had anterior cerebral artery involvement (P=.05) and cortical and subcortical lesions (P=.001) were at higher risk of developing PSE
• No significant differences were observed in PSE risk for patients treated with angiotensin-converting enzyme inhibitors (ACEi)

These results demonstrate the potential utility of ARBs as a frontline treatment strategy to reduce the risk of epilepsy in patients with a history of hypertension and stroke.