People with Epilepsy More Likely to Have Anxiety and Mood Disorders, Hypertension Large Study Shows Racial Disparities, Medicaid Status Increase Risk

CHICAGO – Medicaid recipients with epilepsy are more likely to have anxiety and mood disorders and hypertension (high blood pressure) compared to both the general population and people with epilepsy who aren’t enrolled in Medicaid, according to a large national study presented at the American Epilepsy Society Annual Meeting. The study also identified racial disparities in the prevalence of these health conditions.

“Our data-driven approach identified previously unknown combinations of conditions in Medicaid recipients with epilepsy, reflecting the complexity of real-life for these patients,” said Wyatt Bensken, B.S., lead author of the study and a doctoral candidate in epidemiology and biostatistics at Case Western Reserve University in Cleveland. “The difference may be due to various factors, as stigma that people with epilepsy face increases the risk of some of these conditions. There also may be shared underlying biological pathways or these conditions can be precursors to epilepsy. For example, we know that high blood pressure increases the risk of stroke, which can cause epilepsy – making hypertension more prevalent among people with epilepsy.”

Using machine learning techniques, researchers analyzed Medicaid data from 16 states between 2010 and 2014, identifying 81,963 people with epilepsy.* They determined that among Medicaid recipients with epilepsy:

• 46.5% had anxiety and mood disorders, 36.9% had hypertension, 35.2% had back problems, 31.6% had developmental disorders (such as developmental delays and learning disorders) and 29.5% had headache including migraine.
• The most common combination of four conditions was anxiety and mood disorders, injuries, back problems and headache, which affected 9.1% of patients.
• The prevalence of anxiety and mood disorders was 20% higher and the prevalence of hypertension was 7% higher than the general population when compared to previous studies.
• There was a higher prevalence of anxiety and mood disorders (46.5% vs. 20-40%) and hypertension (36.9% vs. 12-25%) compared to people with epilepsy who weren’t Medicaid recipients.
• 52.7% of Black patients had high blood pressure compared to 33.3% of white patients.
• Black patients, American Indians, and Alaskan natives had the highest prevalence of any combination of three or more of conditions analyzed (e.g., mood and anxiety disorders, high blood pressure, back problems, developmental disorders, and headaches).

“It is critically important to recognize that epilepsy does not occur in isolation,” said Siran Koroukian, Ph.D., senior author, and professor of population and quantitative health sciences at Case Western Reserve University. “Our study shows it’s vital for people with epilepsy to be treated by a multidisciplinary team to address all of the patients’ health issues, which can help improve their epilepsy care, outcomes, and quality of life.”