Is Cardiovascular Mortality Among People with Epilepsy increasing? A retrospective US population study

Area of Science:

• Epidemiology
• Cardiovascular Health
• Neurology

Background:

• Individuals with epilepsy face higher risks of hypertension, diabetes, hyperlipidemia, and obesity compared to the general US population.
• It remains unclear if these elevated risk factors contribute to increased cardiovascular mortality in epilepsy patients.

Purpose of the Study:

• To investigate the trends in cardiovascular mortality among individuals with epilepsy in the USA.
• To compare cardiovascular death proportions in people with epilepsy against the general US population from 2000 to 2019.

Main Methods:

• A retrospective, longitudinal study analyzed US death data from 2000-2019 using CDC Multiple Cause of Death Database.
• Epilepsy deaths were identified using ICD-10 codes G40.0-G40.919; cardiovascular deaths included ischaemic heart disease, cerebrovascular disease, diabetes, and hypertension.
• Data were stratified by age, race, and gender, with relative proportions analyzed using logistic regression and standardized proportions.

Main Results:

• Age-adjusted mortality for cerebrovascular disease and diabetes significantly increased in people with epilepsy versus the general population (p<0.001).
• Increases in cerebrovascular disease and diabetes deaths were most pronounced in the 35-64 age group.
• A trend reversal was observed for ischaemic heart disease deaths post-2011, with proportions stabilizing in epilepsy patients while continuing to decline in the general population.

Conclusions:

• Significant increases in age-standardized deaths from cerebrovascular disease and diabetes were observed in people with epilepsy (2000-2019).
• These increases were primarily seen in the 35-64 age range, indicating a critical window for intervention.
• The stabilization of ischaemic heart disease mortality, contrasting with the general population's decline, suggests a need for enhanced cardiovascular risk factor management in epilepsy care.