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Updated: Jul 4, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Hypertension and other vascular risk factors in patients with functional seizures
1Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
Insights
Patients with functional seizures exhibit higher rates of vascular disease risk factors like hypertension, hyperlipidemia, and obesity compared to epilepsy patients. These findings highlight potential links between functional seizures and cardiovascular complications.
Area of Science:
- Neurology
- Cardiology
- Psychiatry
Background:
- Recent literature suggests a link between functional seizures and increased vascular disease risk.
- Understanding the prevalence of vascular risk factors in patients with functional seizures is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the prevalence of vascular disease risk factors in patients admitted to an epilepsy monitoring unit.
- To compare vascular risk factor profiles between patients diagnosed with functional seizures and those with epilepsy.
Main Methods:
- A cohort of patients diagnosed with functional seizures or epilepsy was identified from an epilepsy monitoring unit.
- Demographic, clinical, comorbidity, and medication data were collected.
- Mean blood pressures were calculated and compared against established guidelines (130/80 mm Hg). Logistic regression analysis was used to assess the association between diagnosis and vascular risk factors, controlling for covariates.
Main Results:
- Functional seizure patients (123) showed a significantly higher prevalence of hypertension or elevated mean blood pressure (57.72%) compared to epilepsy patients (147) (38.78%; p=0.0022).
- Functional seizures were independently associated with higher odds of hypertension (OR: 2.47), hyperlipidemia (OR: 3.38), and obesity (OR: 4.25) compared to epilepsy.
- No significant differences were observed in the prevalence of diabetes or current tobacco use between the groups.
Conclusions:
- Patients diagnosed with functional seizures present with a greater prevalence of key vascular risk factors.
- These elevated risk factors may contribute to the observed vascular complications in functional seizure patients.
- The findings have implications for understanding the pathophysiology and management of functional seizures.
Objective:
Recent literature has suggested that functional seizures are associated with an elevated risk for vascular disease and mortality. We investigated the prevalence of risk factors for vascular disease in patients who were admitted to the epilepsy monitoring unit.
Methods:
Patients who were admitted to the epilepsy monitoring unit and received a definitive diagnosis of either functional seizures or epilepsy were identified. Data collected included demographic, clinical characteristics, medication list, comorbidities, and scheduled blood pressure measurements that occurred every 12 h during the admission. The mean blood pressures were calculated and if they were above the American College of Cardiology and the American Heart Association guideline cutoff of 130/80 mm Hg or the patient had a documented history of hypertension the patient was counted as having the condition. A multiple logistic regression model was developed to evaluate the independent association of the patient's diagnosis (i.e., epilepsy or functional seizures) and vascular risk factors that controlled for the number of blood pressure measurements, age, sex, and if the patient was taking antihypertensive medications.
Results:
270 patients were included in this study of which 147 patients had epilepsy and 123 had functional seizures. Among those with functional seizures, 57.72 % had either a history of hypertension or a mean blood pressure above 130/80 compared to 38.78 % of those with epilepsy (p = 0.0022). In addition, 30.89 % of functional seizures patients had hyperlipidemia and 63.41 % were obese. The logistic regression model indicated that functional seizures were independently associated with high blood pressure (OR: 2.47, 95 % CI 1.10-5.69), hyperlipidemia (OR: 3.38, 95 % CI 1.35-8.86), and obesity (OR: 4.25, 95 % CI 2.22-8.36) compared to those with epilepsy. There was no significant difference in the prevalence of diabetes (OR: 0.81, 95 % CI 0.24-2.77) or current tobacco use (OR: 1.04, 95 % CI 0.48-2.25) between the groups.
Significance:
Patients with functional seizures had an elevated prevalence of several vascular risk factors. These findings may partially account for complications associated with functional seizures and have implications related to their pathophysiology.
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