A study found an increased risk of major cardiovascular events in the people with epilepsy taking antiepileptic drugs. Epilepsy is often associated with increased mortality explained by comorbid conditions, lifestyle factors or cardiovascular events. Antiepileptic drugs are linked to lipid abnormalities, alterations in metabolic pathways, changes in homocysteine and C-reactive protein levels which contribute to vascular risk. 10,241 epilepsy patients receiving antiepileptic drugs and 35,145 matched controls were studied to assess the risk of cardiovascular events and to compare the cardiovascular outcomes in those receiving enzyme-inducing and non-enzyme-inducing antiepileptic drugs. A higher risk of major cardiovascular events was observed in epilepsy patients receiving antiepileptic drugs than the matched control cohort (adjusted hazard ratio = 1.58, 95% CI = 1.51–1.63). Significant difference was not observed in the adjusted risk ratio between enzyme-inducing and non-enzyme-inducing antiepileptic drugs. However, non-enzyme-inducing antiepileptic drugs had a slightly higher rate of cardiovascular events in the unadjusted analysis with higher prescriptions in those older than 75 years. Healthcare provider and epilepsy patients must prioritize early identification cardiovascular disease and its risk factors. Incorporation of dietary changes, increased physical activity, quitting smoking while addressing hypertension and hypercholesterolemia may improve overall prognosis of such patients.
