A landmark study led by Stanford Medicine suggests that angiotensin receptor blockers, an inexpensive class of blood pressure medications, could prevent epilepsy. This discovery could transform epilepsy prevention.
Researchers led by Stanford Medicine have unveiled a promising discovery that could redefine the preventive strategies for epilepsy. According to their recent study, a class of drugs commonly used to treat high blood pressure might also significantly reduce the risk of developing epilepsy.
The breakthrough, detailed in the June 17 issue of JAMA Neurology, highlights the potential for angiotensin receptor blockers (ARBs) to prevent epilepsy, particularly among older adults who have suffered strokes.
“This is incredibly exciting because we don’t currently have any medicines that prevent epilepsy,” Kimford Meador, the study’s senior author and professor of neurology and the neurosciences at Stanford, said in a news release. “I hope these initial findings lead to randomized clinical trials.”
Epilepsy, which is often diagnosed in childhood, also affects over 1% of individuals older than 65, many of whom experience recurring seizures — a disruptive and potentially debilitating symptom. While anti-seizure medications help manage the condition post-diagnosis, there are currently no approved drugs that prevent epilepsy in high-risk individuals.
Strokes are the primary risk factor for epilepsy among older adults, with about 10% of stroke survivors encountering seizures within five years. Both vascular disease and chronic high blood pressure also elevate the risk of developing the disorder.
Earlier studies hinted at ARBs’ potential to quell seizures by reducing inflammation — a likely trigger for post-stroke or traumatic brain injury-related epilepsy. Notably, a 2022 study involving over 160,000 individuals in Germany revealed that ARB usage was associated with a decreased risk of epilepsy.
“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 United States,” said Meador.
To validate these findings, Meador and his team tapped into a vast national database of health care claims, assessing more than 2 million Americans with high blood pressure but without epilepsy.
Their analysis showed that people on ARBs faced a 20% to 30% lower risk of developing epilepsy between 2010 and 2017 compared to those on other blood pressure medications. Crucially, this reduced risk persisted even when stroke patients were excluded, suggesting ARBs’ broader protective benefits.
“What we’ve done is replicate what was found in Germany but in a larger and completely different population,” Meador added. “That really increases the strength of the signal and tells us that there’s something real going on here.”
Particularly, the ARB losartan — an inexpensive medication — demonstrated a powerful effect in decreasing epilepsy risk, though further research is essential to confirm this observation.
As high blood pressure is a known contributor to epilepsy, managing it through any combination of drugs and lifestyle changes could inherently lower epilepsy risk. Yet, the study hints that ARBs might offer superior protection compared to other antihypertensive medications.
“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.”
Before these findings can alter treatment protocols, randomized clinical trials are necessary to firmly establish the link between ARB usage and reduced epilepsy risk, according to Meador.