Association between seizure, epilepsy and the angiotensin receptor blocker therapy in patients after acute stroke

Introduction To further clarify the association between angiotensin receptor blocker therapy and post-stroke seizures, we analysed a database of patients with acute stroke. Methods This single-centre, retrospective observational study included patients with acute stroke admitted to our hospital between 1 January 2019 and 31 December 2023. Patients were allocated into two groups based on whether they received angiotensin receptor blocker therapy. The primary outcome was the incidence of any seizure in the two groups. Predictors of seizure occurrence were assessed in univariable and multivariable logistic regression models. Results A total of 2589 patients were enrolled; the mean age was 72 years (SD 13.2), and the majority were female (n = 1306, 50.4%). The median follow-up duration was 18 months (IQR 3–31). A total of 243 patients experienced at least one seizure, including acute symptomatic seizures only (n = 101), post-stroke epilepsy (n = 92), or both (n = 50). The differences in seizure incidence were significant across all three groups ( P < 0.05), and angiotensin receptor blocker therapy remained a significant factor in the multivariable logistic regression model ( P < 0.001). Conclusions Based on our results, angiotensin receptor blocker therapy is independently associated with a lower incidence of both acute symptomatic seizures and post-stroke epilepsy.