Do males 30-50 years of age with chronic epilepsy and on long-term anticonvulsant medication have lower-than-expected risk of developing coronary heart disease?
OBJECTIVE
It has been claimed that long-term use of antiepileptic drugs (AEDs) brings about changes in the lipid profile which might resist development of cardiovascular disease. The aim of this study was to test the following hypothesis: Do males with chronic epilepsy and on long-term treatment with AEDs have a lower than expected risk of developing coronary heart disease?


METHODS
The coronary risk profile in 40 male patients with chronic epilepsy, aged 30-50 years, was explored, using an American individual coronary risk factor test program (the Cooper test). We made a survey of the patients' risk factors: total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, glucose, blood pressure, body fat percentage, physical fitness, hereditary factors, smoking habits, and degree of stress. Each factor was given a score, and the sum of scores constituted the total coronary risk profile. Eighty men in the same age group, casually selected from an industrial medical service, served as controls.


RESULTS
There was no statistically significant difference in the total coronary risk profile between the epilepsy patients and the controls. Nor were there any significant differences among the individual risk factors except for physical fitness level, which was significantly lower among the epilepsy group than among the controls. In the epilepsy group, however, there was a trend toward higher levels of total cholesterol, higher levels of HDL-cholesterol, lower levels of total cholesterol/HDL-cholesterol ratio, increased body fat percentage, greater heredity and somewhat greater coronary risk score as compared with the healthy controls, but the differences did not reach statistical significance. The protective effect against coronary heart disease exercised by the enzyme-inducing AEDs seems to be counteracted by other factors, like reduced physical fitness and increased body fat percentage.


CONCLUSIONS
Our hypothesis was not confirmed, because we found that the 40 patients with chronic epilepsy tested had about the same risk of developing coronary heart disease as did the control group.
Nakken
K O
KO
The National Center for Epilepsy, Sandvika, Norway.
Kornstad
S
S
D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001823:Body Composition; D001824:Body Constitution; D002784:Cholesterol / Q000097:blood; D002908:Chronic Disease; D003327:Coronary Disease / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D006304:Health Status; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood
D000927:Anticonvulsants; D001786:Blood Glucose; D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol