Angiotensin receptor blocker therapy in patients after acute stroke was significantly associated with a lower risk of seizures (OR 0.38; 95% CI 0.21-0.68; P<.001).
Cohort (n=2,589)
No
Does ARB therapy reduce the incidence of seizures in adult patients after acute stroke?
ARB therapy is independently associated with a significantly lower incidence of acute symptomatic seizures and post-stroke epilepsy in patients following acute stroke.
Odds Ratio: 0.38 (95% CI 0.21–0.68)
p-value: p=<.001
Objective: Previous researches revealed a significant association between angiotensin receptor blocker (ARB) therapy and reduced epilepsy incidence in patients with hypertension. In addition, based on our former research we showed that ARB therapy in patients with acute stroke was associated significantly with lower incidence of acute symptomatic seizure (ASS). With the current study, our aim was to assess further associations between ARB therapy and seizures including also post-stroke epilepsy (PSE) in higher number of patients with acute stroke. Design and method: The study was retrospective cohort with longitudinal follow-up, observational referral-centre one. The patient's data was collected retrospectively from our electronic medical records. We enrolled all consecutive adult patients who were admitted into our stroke centre with acute stroke from 1st January 2019 to 31st December 2023. The statistical analysis was performed by R statistic program, version 4.2.3. In order to statistical analysis we allocated the patients into two subgroups according to present of ARB therapy and then we did the following tests: t-test for independent samples, z-test and Chi-squared test and univariate, multivariate logistic models. The study was approved by the Institutional Research Ethics Committee of our hospital. Results: We enrolled 2589 patients, mean age was 72.0 ±13.2 years (women were 50.4%) and the median follow-up time was 18 months (IQR 3–31). In ARB treated group percentages of all seizure types were significantly lower: the ASS (n=101), (2.1% vs. 4.2%; P=.045); the only PSE (n=92), (1.6% vs. 3.9%; P=.017); the only PSE and ASS together (n=50), (0.5% vs, 2.2%; P=.026). After adjusted the data for age and gender in univariate model the ARB therapy was a significant protective factor (OR, 0.39; 95% CI, 0.23-0.65; P<.001) against seizure. Similarly in multivariate model the ARB therapy remained significant parameter (OR, 0.38; 95% CI, 0.21-0.68; P<.001) for seizure. Conclusions: Based on our current study the ARB therapy independently and significantly associates with lower incidence of not only ASS, but also PSE in patients after acute stroke. Our results suppose the anti-seizure, neuroprotective and anti-epileptogenic characteristics of ARB therapy, which require further researches in this area.
Kiss et al. (2026) conducted a cohort in Acute stroke (n=2,589). Angiotensin receptor blocker (ARB) therapy vs. No ARB therapy was evaluated on Seizure (including acute symptomatic seizure and post-stroke epilepsy) (OR 0.38, 95% CI 0.21-0.68, p=<.001). Angiotensin receptor blocker therapy in patients after acute stroke was significantly associated with a lower risk of seizures (OR 0.38; 95% CI 0.21-0.68; P<.001).