Abstract Details

Title Cardiovascular Mortality in Epilepsy: A US Population Study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S41 - Epilepsy: Public Health and Epidemiology (2:24 PM-2:36 PM)

Poster/Presentation
Number 008

Objective

To determine if mortality in the United States due to ischemic heart disease, hypertension, diabetes, and stroke is increasing in epilepsy compared with the US General Population

Background People with epilepsy are at elevated risk for cardiovascular disease and stroke compared with the general population. In epilepsy, atherosclerotic disease risk (as measured by the ACC-ASCVD risk calculator) are elevated in epilepsy compared to those without. Contributing factors include higher rates of poverty, poor diet, sedentary lifestyle, antiseizure medications and developmental disability.

Design/Methods

Retrospective US population study of all deaths in epilepsy and the general population due to ischemic heart disease, hypertension, diabetes and stroke for the years 2000 through 2019 (pre-pandemic). Source data were obtained from the CDC Multiple Cause-of-Death Database using all ICD-10 codes for epilepsy (G40.0 through G40.9). Data was stratified by age, race, and gender. Relative proportions of each cause-of-death were expressed as a percentage of total deaths and evaluated on the log-odds scale using a logistic regression model. Age standardized proportions were also utilized and reported.

Results Age-adjusted proportions of deaths due to cerebrovascular disease and diabetes increased significantly in epilepsy compared with the general population for ages 35-64. From 2000-2010, the proportion of deaths due to ischemic heart disease in epilepsy declined at a slope of – 0.265 similar to the US general population. After 2011, the slope changed from - 0.265/year to zero. This was significantly different than the continued decline in the US general population (slope difference p <0.001 after 2011).

Conclusions Deaths due to cerebrovascular disease and diabetes increased in people with epilepsy compared with the US population. This was most significant in those aged 34–65 where risk factor modification can prevent cardiovascular deaths. A highly concerning finding is the end of the long-term decline in ischemic heart disease mortality in people with epilepsy after 2011.

Authors/Disclosures
Ashley T. Curtis PRESENTER	Miss Curtis has nothing to disclose.
Christopher M. DeGiorgio, MD, FAAN (UCLA Department of Neurology At Olive View)	Dr. DeGiorgio has received intellectual property interests from a discovery or technology relating to health care.
Andrew Liao	Mr. Liao has nothing to disclose.
Mark Gaertner, MD (UCLA Medical Center)	Dr. Gaertner has nothing to disclose.
Somnath V. Ganapa, MD	Dr. Ganapa has nothing to disclose.
Daniela Markovic (UCLA)	Daniela Markovic has nothing to disclose.