Hypertension is associated with a 2.5-fold increased risk for developing epilepsy in older age, and this risk may be mitigated with hypertension treatment, according to study results presented at the American Epilepsy Society 2019 Annual Meeting, held in Baltimore, Maryland from December 6 to 10.

While stroke is a known cause for epilepsy in older age, recent studies have attempted to explore the association between vascular risk factors and epilepsy. The goal of the current study was to explore the association between modifiable vascular risk factors – including hypertension, diabetes mellitus, smoking, and hyperlipidemia – and epilepsy among patients aged ≥45 years.

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The researchers reviewed data on 2986 participants (mean age 58, 48% male) of the offspring cohort who attended Framingham Heart Study exam 5 between 1991 and 1995.

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During a follow-up period of 1-25 years (mean 19.2 years) there were 55 cases of new-onset epilepsy.

Following adjustment for stroke history, hypertension was associated with a 2-fold increased risk for developing epilepsy (hazard ratio [HR], 1.97; 95% CI, 1.13-3.45; P =.017). The association between hypertension and increased risk for epilepsy was stronger after exclusion of patients treated with high blood pressure medications (HR, 2.44; 95% CI, 1.36-4.35; P =.003).

The researchers identified an association between history of cardiovascular disease and atrial fibrillation with epilepsy, but this was not statistically significant.

“Our results offer further evidence that hypertension, a vascular risk factor which is highly prevalent in the general population, increases 2.5-fold the risk [for] developing epilepsy in older age, even in the absence of a clinical stroke,” concluded the researchers.


Stefanidou M, Himali J, Devinsky O, Beiser A, Seshadri S, Friedman D. Vascular risk factors as predictors of epilepsy in older age: The Framingham Heart Study. Presented at: The American Epilepsy Society 2019 Annual Meeting; December 6-10, 2019; Baltimore, MD. Abstract 2.386.