Severe, uncontrolled hypertension and adult-onset seizures: a case-control study in Rochester, Minnesota.
OBJECTIVE
Hypertension is an established risk factor for clinically detected stroke, which is in turn a risk factor for epilepsy. This relation suggested that hypertension, particularly severe and uncontrolled, might increase the risk of epilepsy in the absence of prior clinically detected stroke.


METHODS
Subjects in this population-based case-control study were the 145 incident cases of first unprovoked seizure aged 55 years or older and 290 controls matched to cases on age, gender, and duration of medical follow-up. Using the records-linkage system of the Rochester Epidemiology Project, we obtained, for both cases and matched controls, all blood pressure readings before each case's first seizure came to medical attention. Subjects were classified as hypertensive if they had at least two readings of > or = 160/95 mm Hg or if there was electrocardiographic evidence for left ventricular hypertrophy.


RESULTS
Severe uncontrolled hypertension increased the risk of unprovoked seizure. Left ventricular hypertrophy without diuretic treatment was associated with an 11-fold increased risk of unprovoked seizure: left ventricular hypertrophy treated with diuretics did not increase the risk.


CONCLUSIONS
In the absence of clinically detected stroke, left ventricular hypertrophy without diuretic use may increase the risk of unprovoked seizures, and diuretic treatment may protect against this increased risk.
Hesdorffer
D C
DC
G. H. Sergievsky Center, Columbia University, New York, NY 10032, USA.
Hauser
W A
WA
Annegers
J F
JF
Rocca
W A
WA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015897:Comorbidity; D004232:Diuretics / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology*
D004232:Diuretics