STROKE survivors with hypertension may have a new ally in reducing their risk of post-stroke epilepsy (PSE): angiotensin receptor blockers (ARBs). A first-of-its-kind study presented at the American Epilepsy Society (AES) Annual Meeting 2024 found that ARBs outperform other antihypertensive drugs in lowering epilepsy risk in this vulnerable population.
Stroke remains the leading cause of seizures in individuals aged 60 and older, and hypertension further elevates the risk. This study analyzed data from 528 patients with high blood pressure who had experienced a stroke but were epilepsy-free at the time. Patients were categorized based on their antihypertensive medication.
Of the participants, 38 (7.2%) developed PSE. ARBs demonstrated the strongest protective effect: patients taking other antihypertensive drugs were significantly more likely to develop PSE—beta-blockers by 120%, calcium channel blockers by 110%, ACE inhibitors by 65%, and diuretics by 60%.
ARBs may reduce epilepsy risk by blocking the angiotensin II type 1 receptor, which is associated with vascular narrowing, inflammation, and increased brain excitability. Conversely, some other antihypertensive drugs may inadvertently heighten seizure risk by affecting brain excitability.
“These findings highlight the importance of personalized medicine, particularly in managing blood pressure in stroke patients,” said co-lead author Fedele Dono.
With PSE affecting 6%-8% of ischemic stroke survivors, this research underscores the need for targeted therapy to optimize recovery. Further studies are planned to confirm these results and delve deeper into the mechanisms behind ARBs’ protective effects.
Reference: San Antonio Breast Cancer Symposium. (2024, December 9). Common Blood Pressure Drug May Help Reduce Increased Risk of Epilepsy after a Stroke. Presented at AES 2024.
Anaya Malik | AMJ
