Existing high blood pressure drugs may prevent epilepsy, Stanford Medicine-led study finds

“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 said. 

A bigger, broader data set

For the new study, Meador and colleagues at the University of Rhode Island turned to a national database that includes information on health care claims from more than 20 million Americans enrolled in either commercial health insurance plans or Medicare — a group more racially diverse than that in the German study. They focused their analysis on 2.2 million adults who had been diagnosed with high blood pressure, were prescribed at least one high blood pressure medication and did not already have epilepsy. 

Overall, people taking angiotensin receptor blockers had a 20% to 30% lower risk of developing epilepsy between 2010 and 2017 compared with people taking other blood pressure drugs. This difference held true even when patients with strokes were removed from the analysis, suggesting that the lower rates of epilepsy were not a result solely of a decreased risk of stroke. 

“What we’ve done is replicate what was found in Germany but in a larger and completely different population,” Meador said. “That really increases the strength of the signal and tells us that there’s something real going on here.”

The data also indicated that one particular angiotensin receptor blocker — losartan — had the most powerful effect on lowering epilepsy risk, but the researchers said more work is needed to confirm that. 

Toward clinical trials

All blood pressure medications likely have an impact on decreasing epilepsy risk because high blood pressure is a contributing factor to epilepsy. Keeping blood pressure under control through any combination of antihypertensive drugs and lifestyle factors can therefore lower a person’s chance of developing epilepsy, Meador said. 

However, the new research suggests that angiotensin receptor blockers might be more beneficial than other antihypertensives for patients to reduce the risk of epilepsy. In the new study, about 14% of people taking a blood pressure drug took angiotensin receptor blockers, while most took other classes of drugs to control their blood pressure, including beta blockers, calcium channel blockers and angiotensin-converting enzyme inhibitors. 

“This could be a new chapter in the story of preventive medicine,” Meador said. “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.”

However, Meador added, randomized clinical trials are needed to prove the association between angiotensin receptor blockers and reduce epilepsy risk before treatment guidelines change. 

Researchers from Brown University were also involved in the research. 

The researchers have no outside funding sources or conflicts of interest to disclose.