Researchers combined results from 31 studies to understand how epilepsy and seizure medications affect heart health. They found that people with epilepsy show early signs of artery hardening compared to people without epilepsy. Older seizure medications and taking multiple medications at once seemed to increase this risk more than newer medications. The good news is that special diets and vitamin supplements didn’t make a significant difference. This research suggests that people with epilepsy might benefit from extra heart health monitoring and preventive care to catch problems early.

The Quick Take

  • What they studied: Whether epilepsy, seizure medications, and related treatments affect how quickly arteries start to harden (a condition called subclinical atherosclerosis)
  • Who participated: 31 different research studies involving people with epilepsy compared to people without epilepsy. The exact total number of participants wasn’t specified in the summary
  • Key finding: People with epilepsy had measurably thicker artery walls (a sign of early hardening) compared to people without epilepsy. This difference was even more pronounced in people taking older seizure medications or multiple medications at once
  • What it means for you: If you have epilepsy, your doctor may want to monitor your heart health more closely. Switching to newer seizure medications or taking fewer medications (if medically appropriate) might help reduce this risk. However, this research shows what happens on average—your individual risk depends on many factors

The Research Details

This was a meta-analysis, which means researchers searched for all published studies on this topic and combined their results to see the bigger picture. They looked at 31 different studies that measured three specific markers of early artery hardening: how thick the inner lining of neck arteries had become (cIMT), how much fat had accumulated around the heart (EATT), and how well blood vessels could expand when needed (FMD). By combining data from many studies, researchers could spot patterns that might not be obvious in any single study.

The researchers carefully compared different groups: people with epilepsy versus people without epilepsy, people taking old seizure medications versus new ones, people taking one medication versus multiple medications, and people using different types of treatments like special diets or vitamin supplements. This allowed them to identify which factors had the biggest impact on artery health.

A meta-analysis is powerful because it combines evidence from many studies, making the results more reliable than any single study alone. By looking at 31 different research projects, the researchers could identify consistent patterns about how epilepsy and its treatments affect heart health. This approach helps doctors understand the real-world impact of these conditions and medications

This research combined multiple studies, which generally makes findings more trustworthy. However, the studies included may have had different methods and quality levels. The fact that some comparisons showed clear results while others didn’t suggests the evidence is stronger for some conclusions than others. The researchers were transparent about which findings were statistically significant and which weren’t, which is a good sign of careful analysis

What the Results Show

People with epilepsy showed thicker artery walls compared to people without epilepsy—a clear sign of early artery hardening. This difference was small but consistent across the studies reviewed. When researchers looked at which seizure medications made the biggest difference, they found that older medications caused more artery thickening than newer ones. People taking multiple seizure medications at once also showed more artery thickening than those taking just one medication.

Interestingly, medications that work by speeding up the body’s metabolism (enzyme-inducing medications) seemed to have a stronger effect on artery hardening than other types of seizure drugs. This suggests the way a medication works in the body matters for heart health, not just the medication itself.

The researchers also looked at whether special diets (like the ketogenic diet or Atkins diet) or vitamin supplements helped protect the arteries. These treatments didn’t show a significant protective effect in the studies reviewed, though this doesn’t mean they’re not helpful for other reasons.

The research found that the thickness of fat around the heart and how well blood vessels could expand didn’t show clear differences between groups in most comparisons. This suggests that artery wall thickness might be the most reliable early warning sign of heart problems in people with epilepsy. The fact that different measurements told slightly different stories highlights that early artery damage is complex and may affect different parts of the cardiovascular system in different ways

This research builds on earlier studies suggesting that people with epilepsy face higher risks for heart and blood vessel problems. By combining all available evidence, this meta-analysis confirms those concerns and provides clearer information about which medications and treatments matter most. The finding that newer seizure medications appear safer for heart health aligns with what doctors have suspected based on how these newer drugs work in the body

The researchers couldn’t specify the exact total number of people studied because they were combining different studies with different sizes. Some of the studies included were small, which can make results less reliable. The studies measured artery health in different ways, which required careful statistical adjustment. The research shows associations (things that happen together) but can’t prove that seizure medications directly cause artery hardening—other factors in people’s lives could play a role. Additionally, the studies didn’t all measure the same outcomes, so some conclusions are based on fewer studies than others

The Bottom Line

If you have epilepsy, discuss heart health monitoring with your doctor. Ask whether your current seizure medications are the best choice for you, particularly if you’re taking older medications or multiple drugs. Your doctor may recommend periodic heart health checks, especially if you have other risk factors like high blood pressure, high cholesterol, or a family history of heart disease. These recommendations are based on solid evidence but should be personalized to your specific situation

This research is most relevant for people with epilepsy, their families, and their doctors. It’s particularly important for people who have had epilepsy for many years, those taking multiple seizure medications, or those taking older medications. People without epilepsy don’t need to worry about these specific findings. If you’re considering starting seizure medication, this information might be worth discussing with your neurologist

Artery hardening develops slowly over years, so you won’t notice changes immediately. Heart health improvements from switching medications or lifestyle changes might take months to years to become measurable. This is why regular monitoring over time is important rather than expecting quick results

Want to Apply This Research?

  • Track blood pressure readings weekly and note any changes in energy levels or exercise tolerance. Record which seizure medications you’re taking and any changes to your medication regimen. This creates a personal health timeline you can share with your doctor
  • Set a reminder for regular cardiovascular exercise (like brisk walking for 30 minutes most days), which helps keep arteries healthy. Use the app to log exercise sessions and monitor consistency. Also track heart-healthy eating habits like increasing vegetables and reducing processed foods
  • Schedule and log regular doctor visits for heart health checks (blood pressure, cholesterol screening, and potentially imaging tests). Use the app to record test results over time so you and your doctor can spot trends. Set annual reminders to discuss your seizure medications with your neurologist to ensure you’re on the most appropriate treatment

This research summary is for educational purposes only and should not replace professional medical advice. The findings describe average effects across studies and may not apply to every individual. If you have epilepsy or take seizure medications, discuss these findings with your neurologist or cardiologist before making any changes to your treatment plan. Do not stop or change seizure medications without medical supervision, as this could be dangerous. Your doctor can help determine your individual risk and recommend appropriate monitoring or preventive measures based on your specific health situation.