Trinh Ilene, Shaia Jacqueline K, Kaelber David, Singh Rishi P, Talcott Katherine E, Cohen Devon A
Case Western Reserve School of Medicine, Cleveland, Ohio, United States.
Case Western Reserve University Department of Population and Quantitative Health Sciences, Cleveland, Ohio, United States; Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States.
Clin Neurol Neurosurg. 2025 Nov;258:109158. doi: 10.1016/j.clineuro.2025.109158. Epub 2025 Sep 12.
Idiopathic intracranial hypertension (IIH) is a neurometabolic disease that can cause debilitating vision loss and headaches, and is associated with obesity. Recent studies have suggested an increased risk of cardiovascular disease in patients with IIH, although data is scarce. The objective of this study was to investigate the prevalence of cardiovascular and cerebrovascular events and associated risk factors in patients with IIH.
A cross-sectional study was conducted using a large aggregate multicenter research platform (TriNetX) consisting of 70 healthcare organizations in the United States with over 115 million patients. Prevalence of outcomes including cerebrovascular disease (CVD), myocardial infarction, heart failure, essential hypertension (HTN), and type II diabetes mellitus (DM) were calculated and compared between the IIH group and two controls: the general population and patients with high body mass index (BMI ≥ 30 kg/m). Chi Square two-sided tests were used to compare groups where a p-value of < 0.01 was deemed significant. Prevalence odds ratios (OR) were performed and 95 % confidence intervals calculated.
CVD prevalence was 7.13 % in IIH patients compared to 3.13 % in the total population and 5.47 % in high BMI controls (p < 0.0001). With age stratification, CVD rates were higher in IIH patients at ages 0-70 compared to the total population and high BMI patients (p < 0.0001). IIH patients had 2.38 times increased odds of having CVD compared to the total population (95 % CI, 2.26-2.50) and 1.33 times increased odds compared to high BMI patients (95 % CI 1.26-1.40). Prevalence of HTN was 23.1 % in IIH patients, which was higher compared to the total population (14.48 %) and lower compared to high BMI controls (35.66 %) (p < 0.0001). However, HTN rates were higher in IIH patients at earlier ages (0-60) (p < 0.0001). Compared to high BMI controls, IIH had decreased odds of DM and myocardial infarction (p < 0.01).
Patients with IIH had significantly higher rates of CVD and HTN in patients ≤ 60 years of age compared to the general and obesity populations in the United States. Therefore, we recommend early screening for these morbidities in the setting of IIH.
特发性颅内高压（IIH）是一种神经代谢性疾病，可导致使人衰弱的视力丧失和头痛，且与肥胖有关。近期研究表明，IIH患者患心血管疾病的风险增加，尽管相关数据较少。本研究的目的是调查IIH患者心血管和脑血管事件的患病率及相关危险因素。
采用一个大型综合多中心研究平台（TriNetX）进行横断面研究，该平台由美国70家医疗机构组成，涵盖超过1.15亿患者。计算并比较IIH组与两个对照组（普通人群和体重指数高的患者（BMI≥30 kg/m²））之间包括脑血管疾病（CVD）、心肌梗死、心力衰竭、原发性高血压（HTN）和2型糖尿病（DM）等结局的患病率。采用卡方双侧检验比较组间差异，p值<0.01被认为具有显著性。计算患病率比值比（OR）及95%置信区间。
IIH患者的CVD患病率为7.13%，而普通人群为3.13%，高BMI对照组为5.47%（p<0.0001）。按年龄分层后，0至70岁的IIH患者CVD发生率高于普通人群和高BMI患者（p<0.0001）。与普通人群相比，IIH患者患CVD的几率增加2.38倍（95%CI，2.26 - 2.50），与高BMI患者相比增加1.33倍（95%CI 1.26 - 1.40）。IIH患者的HTN患病率为23.1%，高于普通人群（14.48%），低于高BMI对照组（35.66%）（p<0.0001）。然而，在较早年龄段（0至60岁）的IIH患者中HTN发生率较高（p<0.0001）。与高BMI对照组相比，IIH患者患DM和心肌梗死的几率较低（p<0.01）。
与美国普通人群和肥胖人群相比，60岁及以下的IIH患者患CVD和HTN的比率显著更高。因此，我们建议在IIH患者中对这些疾病进行早期筛查。
