Career Center AES Connect

Abstracts

Angiotensin Receptors Blockers (ARBs) Reduce the Risk of Developing Epilepsy in Patients with Ischemic Stroke and Hypertension

Abstract number : 1.34
Submission category : 4. Clinical Epilepsy / 4C. Clinical Treatments
Year : 2024
Submission ID : 1223
Source : www.aesnet.org
Presentation date : 12/7/2024 12:00:00 AM
Published date :

Authors :
Presenting Author: Giacomo Evangelista, MD, cPhD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy

Fedele Dono, MD, MSc, cPHD, FEBN – Deparment of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara
Sara Melchiorre, Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy – Dep
Clarissa Corniello, MD – Department of Neuroscience Imaging and Clinical Sciences "G. d’Annunzio” University of Chieti-Pescara
Davide Liviello, MD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
Paolo Quintieri, MD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
Michelangelo Dasara, MD, cPhD – Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara
Sara Cipollone, MD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
MIrella Russo, MD, MSc, cPhD – Department of Neuroscience Imaging and Clinical Sciences "G. d’Annunzio” University of Chieti-Pescara
Catello vollono, MD, PhD – Department of Neuroscience, Catholic University of Sacred Heart, Rome Epilepsy Center, IRCCS “A. Gemelli”, Rome
Stefano Luca Sensi, MD, PhD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy

Rationale: Stroke is the most common cause of seizures in patients >60 years. About 6-8% of new epilepsy diagnoses in elderly patients are associated with a brain ischemic event. Among the risk factors for epilepsy and stroke, hypertension is a prominent one. About 2% of patients with epilepsy have hypertension. In addition, hypertension seems to promote the development of seizures in the general population and increases the incidence of epilepsy in post-stroke patients. According to the European Society of Cardiology guideline, Angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blocker (ARBs) drugs should be considered first-line hypertension treatment. ACEi and ARB seem to promote a protective effect in the development of seizures in the general population. However, no data are available about their possible preventive role in post-stroke epilepsy (PSE). This study aims to evaluate the effectiveness of antihypertensive treatment in preventing PSE.

Methods: In this retrospective, observational study, patients with hypertension and diagnosis of ischemic stroke confirmed by clinical and neuroimaging evaluation were retrospectively selected between January 2016 and January 2022. All participants were followed up at a mean of 66 months. Diagnosis of PSE was made according to ILAE criteria. The details of the antihypertensive treatment, as well as demographics and clinical and neuroradiological data, were reviewed.


Results: 528 patients (mean age, 302 men, 57.19%) were enrolled. Thirty-eight (7.2%) patients developed PSE. Anterior Cerebral Artery involvement (p=0.05) and cortico-sottocortical lesions (p=0.001) were related to a higher risk of PSE development. A lower risk of PSE was observed in patients treated with ARBs (p=0.009). PSE incidence was higher among patients receiving Calcium Channel blockers (CCBs) (p=0.019) and Beta-blockers (BBs) (p=0.008). No differences were observed according to ACE.


Conclusions: The results indicate a promising potential role for ARBs in mitigating the risk of epilepsy onset in individuals with hypertension and stroke. This discovery underscores the possibility of utilizing ARBs as a frontline antihypertensive strategy to proactively forestall the occurrence of epilepsy in patients with a history of stroke and hypertension.

Funding: No funding

Clinical Epilepsy