Researchers published in JAMA Neurology on June 17 that angiotensin receptor blockers (ARBs) may prevent epilepsy in high-risk individuals.
“This is incredibly exciting because we don’t currently have any medicines that prevent epilepsy,” said senior researcher Dr. Kimford Meador, a neurology professor at Stanford University School of Medicine. “I hope these initial findings lead to randomized clinical trials.”
Epilepsy is most commonly diagnosed in childhood, although more than 1% of persons over the age of 65 have experienced repeated seizures associated with the brain illness.
Stroke is the most common risk factor for acquiring epilepsy in seniors. Researchers discovered that approximately 10% of stroke patients suffer seizures within five years.
The researchers highlighted that hardened arteries and prolonged high blood pressure increase the chance of epilepsy, regardless of whether a person has had a stroke.
“This can be a very debilitating disorder, and it’s much more common in older adults than people realize,” Meador explained in a Stanford news release.
A 2022 study of more than 160,000 people in Germany discovered that people taking ARBs for high blood pressure had a decreased incidence of epilepsy, according to researchers.
These medications block receptors for angiotensin II, a protein that causes blood vessels to constrict, raising blood pressure. The medications help reduce inflammation in blood arteries and organs, including the brain.
“Those results out of Germany echoed what had been found in animal studies and seemed very promising, but I felt that it was important to reproduce that analysis using data on people in the U.S.,” Meador told me.
For the new study, researchers examined data from 2.2 million persons with high blood pressure who had been prescribed at least one blood pressure medication. None of the participants had epilepsy at the beginning of the trial.
According to the study, approximately 14% of those receiving blood pressure medications were administered an ARB.
Between 2010 and 2017, those taking ARBs had a 20% to 30% decreased chance of getting epilepsy than people on other blood pressure medications.
According to the researchers, this remained true even when those with strokes were excluded from the analysis. This shows that lower rates of epilepsy were not due to ARBs lowering people’s risk of stroke.
“What we’ve done is replicate what was found in Germany, but in a larger and completely different population,” Meador informed the audience. “That increases the strength of the signal and tells us that there’s something real going on here.”
Losartan (Cozaar) was found to be the most effective ARB in reducing epilepsy risk. However, experts stated that more research is needed to substantiate their findings.
All blood pressure medications can reduce the incidence of epilepsy because high blood pressure is a contributing factor, according to the study. However, these results show ARBs may be more effective than other blood pressure medications.
“This could be a new chapter in the story of preventive medicine,” Meador told the audience. “There are so many people with stroke or high blood pressure; knowing that this class of drug not only lowers blood pressure but also helps lower their epilepsy risk could change how we treat them.”
