Abstracts

Rationale: Cardiovascular diseases (CVD) may be preventable comorbidities in epilepsy. People with epilepsy may report more CVD than people without epilepsy because of behavioral risk factors, genetic predispositions, seizure-related damage to the heart, or medication effects. This study compares in the general US population how often adults with epilepsy and adults without epilepsy reported specific common CVD. Methods: The 2013 US National Health Interview Survey (NHIS), a cross-sectional survey of the civilian, non-institutionalized US population, sampled adults ?- 18 years who answered questions about epilepsy and CVD. We considered the 587 adults who answered "Yes" to a question about ever having been told by a doctor or other health professional that they had a seizure disorder or epilepsy as having a history of epilepsy ("any epilepsy") and the remaining 33,946 sampled adults as not having epilepsy. We compared the reported percentages of common CVD (hypertension, coronary heart disease, angina pectoris, heart attack, other heart condition/diseases, and stroke) in those with and without any epilepsy. We adjusted these percentages for sex, age, race/ethnicity, marital status, education level, family income, the ratio of the family income to the poverty level, and region. We defined as statistically significant differences in these adjusted percentages whose two-sided 95% confidence intervals (CI) did not overlap. Results: Compared to people without epilepsy, people with any epilepsy (both men and women) reported significantly more hypertension [36.4% (CI=31.8%-41.3%) vs. 30.2% (CI=29.5%-30.9%)], angina pectoris [3.9% (CI=2.3%-6.5%) vs. 2.0% (CI=1.8%-2.3%)], heart attack [5.2% (CI=3.5%-7.5%) vs. 3.3% (CI=3.0%-3.5%)], other heart condition/diseases [11.8% (CI=8.7%-16.0%) vs. 7.4% (CI=7.0% 7.9%)], and stroke [12.2% (CI=9.5%-15.5%) vs. 2.6% (CI=2.4%-2.9%)] (all P values < 0.01). Women with epilepsy reported significantly more hypertension, [36.4% (CI=31.2%-42.0%) vs. 29.6% (CI=28.8%-30.5)], angina pectoris [3.9% (CI=2.2%-6.8%) vs. 1.7% (CI=1.5%-2.0%)], and stroke [14.1% (CI=10.2%-19.2%) vs. 2.6% (CI=2.2%-2.9%)] than women without epilepsy (all P values < 0.01). However, men with epilepsy reported only significantly more stroke [10.1% (CI=6.9%-14.5%)] than men without epilepsy [2.7% (CI=2.4%-3.1%)] (P < 0.01). Conclusions: CVD are among the most common, potentially preventable comorbidities among people with epilepsy. In this study of a sample representative of the US population, adults with epilepsy reported five of the six most common CVD more often than adults without epilepsy. Men and women with epilepsy reported more stroke than men and women without epilepsy. Only women with epilepsy reported more other selected CVD than women without epilepsy, thus accounting for the overall increased percentages of these CVD in adults with epilepsy. Studying and intervening on the risk factors for these CVD in adults with epilepsy, especially women, may reduce both the risks and the consequences of these CVD and improve quality of life. Funding: None.