Epilepsy, cardiovascular health, and all-cause mortality among adults: A cohort study

Cardiovascular disease is a common comorbidity in people with epilepsy and has been closely associated with mortality risk. This study was undertaken to investigate the associations between epilepsy, cardiovascular health and all-cause mortality risk among US adults using population-level data.

National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018 were used. A total of 12,818 participants aged ≥ 18 years with complete data on epilepsy, cardiovascular health and mortality were included. Weighted logistic regression analysis models were used to explore the association between epilepsy and cardiovascular health. Weighted cox proportional hazard regression models were used to assess the associations of epilepsy and cardiovascular health with all-cause mortality.

Among 12,818 participants, there were 112 participants with epilepsy and 555 deaths (a median follow-up of 49 months) were recorded. Epilepsy was significantly associated with low cardiovascular health after full adjustment. Sensitivity analyses suggested that this association remained significant after excluding individuals with history of cardiovascular disease. Epilepsy and low cardiovascular health were both associated with an increased risk of all-cause mortality. Furthermore, the association between epilepsy and increased mortality risk was partly mediated by cardiovascular health.

People with epilepsy have an increased risk of poor cardiovascular health and all-cause mortality compared with population controls. Poor cardiovascular health partly mediated the impact of epilepsy on mortality risk. Our findings emphasize the importance of cardiovascular health management in the clinical care of people with epilepsy.