Antiseizure Meds May Increase Cardiovascular Risk in Older Adults With Epilepsy
A lifetime history of epilepsy is associated with new-onset cardiovascular events in older adults, according to study results published in JAMA Neurology.
“Almost one-third of this association may result from enzyme-inducing antiseizure medication use,” wrote first author Jimmy Li, MD, of Centre Hospitalier de l’Université de Sherbrooke, Sherbrooke, Québec, Canada, and study coauthors.
The study investigated the odds of new-onset cardiovascular events over 6 years in 27,230 participants from the Canadian Longitudinal Study on Aging. Among participants, 431 had a lifetime history of epilepsy. The mean age was 62.3, and 52.4% of participants were female.
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Adults with a lifetime history of epilepsy were more than double as likely as other participants to report new-onset cardiovascular events, including stroke, transient ischemic attack, or myocardial infarction, according to the study. The adjusted odds ratio was 2.20.
Strong use of enzyme-inducing antiseizure medication mediated the proportion of the effect of epilepsy on new-onset cardiovascular events by 24.6%, the study found. Weak use of enzyme-inducing antiseizure medication mediated the effect by 4.0%.
Mediation analyses also identified a 3.3% effect for Physical Activity Scale for the Elderly score, 1.6% effect for waist to hip ratio, and 1.4% for Framingham score.
“Results suggest that clinicians should be careful when prescribing enzyme-inducing antiseizure medications to older adults with epilepsy,” researchers wrote, “especially in the presence of other cardiovascular risk factors.”
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