The effects of lifestyle modification and statin therapy on the circulatory markers for vascular risk in patients with epilepsy.

Although long-term therapy with antiepileptic drugs can increase the risk of vascular diseases, there have been little attempts to reduce the increased vascular risk in patients with epilepsy. We conducted a prospective longitudinal study to assess the effects of lifestyle modification and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) therapy on the increased circulatory markers for vascular risk in patients with epilepsy. We recruited patients with increased vascular risk such as a history of vascular events or hypercholesterolemia, and they decided whether to be treated with statin or just to modify their lifestyle. The circulatory markers of vascular risk were measured twice before and after a 3-month intervention. A total of 78 patients completed the study, and 37 of them chose to be treated with statin. A 3-month intervention with statin results in significant decreases in homocysteine (p=0.010) and uric acid (p=0.015) as well as total cholesterol (p<0.001) and low-density lipoprotein (LDL) cholesterol (p<0.001). The lifestyle modification group experienced less prominent decreases in total cholesterol (p=0.010) and LDL cholesterol (p=0.012). There were no reports of serious adverse events or seizure aggravation related to the statin treatment. Our findings suggest that lifestyle education is necessary in patients with epilepsy with increased vascular risk and that treatment with statin would be a well-tolerated and effective option for these patients.