Conference Coverage

Cardiovascular Comorbidity Is Common Among Adults With Epilepsy


HOUSTON—Adults with epilepsy report cardiovascular disease more often than adults without epilepsy, according to research presented at the 70th Annual Meeting of the American Epilepsy Society.

In the 2013 US National Health Interview Survey, women with epilepsy reported significantly more hypertension, stroke, and angina pectoris than women without epilepsy. Men with epilepsy reported significantly more stroke than men without epilepsy, said Matthew Zack, MD, MPH, an epidemiologist in the Division of Population Health in the National Center for Chronic Disease Prevention and Health Promotion at the CDC, and colleagues.

Matthew Zack, MD, MPH

Recommending that patients with epilepsy practice healthier behaviors to reduce cardiovascular risk (eg, quitting cigarette smoking, increasing aerobic activity, and eating a healthy diet) “will reduce the burden from these outcomes,” the researchers said. Among patients with cardiovascular disease, adherence to treatments and self-management also will reduce risk, they said.

Cardiovascular diseases are among the most common potentially preventable comorbidities. To compare how often adults with and without epilepsy in the general United States population report common cardiovascular diseases, Dr. Zack and his research colleagues analyzed data from the US National Health Interview Survey, a cross-sectional survey of the civilian noninstitutionalized population.

Participants were age 18 or older and answered questions about epilepsy and cardiovascular disease. In all, 587 adults reported ever having been told by a health professional that they had a seizure disorder or epilepsy, and 33,946 adults did not report a history of epilepsy. Participants also reported whether they had been told by a health professional that they had hypertension, coronary heart disease, angina pectoris, heart attack, other heart condition, or stroke. The investigators adjusted results for age, race/ethnicity, marital status, educational attainment, the ratio of family income to the poverty level, and geographic region.

Compared with people without epilepsy, people with epilepsy reported significantly more hypertension (36.4% vs 30.2%), angina pectoris (3.9% vs 2.0%), heart attack (5.2% vs 3.3%), other heart condition (11.8% vs 7.4%), and stroke (12.2% vs 2.6%). Women with epilepsy reported significantly more hypertension (36.4% vs 29.6%), angina pectoris (3.9% vs 1.7%), and stroke (14.1% vs 2.6%) than women without epilepsy. Men with epilepsy reported significantly more stroke (10.1% vs 2.7%) than men without epilepsy.

People with epilepsy may report more cardiovascular disease than people without epilepsy because of behavioral risk factors, genetic predisposition, seizure-related damage to the heart, or medication effects, the researchers said. The sex-specific differences require further study. The investigators noted that the study’s reliance on self-report increases the likelihood of misclassification of epilepsy status and cardiovascular disease outcomes. In addition, researchers do not know whether cardiovascular outcomes occurred before or after the onset of epilepsy.

Jake Remaly

Suggested Reading

Cui W, Zack MM, Kobau R, Helmers SL. Health behaviors among people with epilepsy—results from the 2010 National Health Interview Survey. Epilepsy Behav. 2015;44:121-126.

Kadima NT, Kobau R, Zack MM, Helmers S. Comorbidity in adults with epilepsy—United States, 2010. MMWR Morb Mortal Wkly Rep. 2013;62(43):849-853.

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