Idiopathic intracranial hypertension tied to CVD risk in women

  • Adderley NJ & al.
  • JAMA Neurol
  • 8 Jul 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Women with idiopathic intracranial hypertension (IIH) had more than twice the risk of cardiovascular events compared with those without IIH.

Why this matters

  • Findings suggest a change in clinical practice that includes assessment and management of cardiovascular disease (CVD) risk factors in IIH may reduce long-term morbidity.

Study design

  • This population-based matched controlled study used data from The Health Improvement Network.
  • 2769 female patients with IIH and randomly matched 27,125 control individuals by body mass index and age were included.
  • Primary outcomes: composite of any CVD (heart failure, ischaemic heart disease, and stroke).
  • Secondary outcomes: CVD outcome, type 2 diabetes, and hypertension.
  • Funding: None disclosed.

Key results

  • Median follow-up was 3.5 years.
  • Women with IIH vs those without had significantly higher risks for cardiovascular outcomes:
    • Compound CVD: adjusted HR (aHR), 2.10; 95% CI, 1.61-2.74; P<.001>
    • Heart failure: aHR, 1.97; 95% CI, 1.16-3.37; P=.01;
    • Ischaemic heart disease: aHR, 1.94; 95% CI, 1.27-2.94; P=.002;
    • Stroke/transient ischaemic attack: aHR, 2.27; 95% CI, 1.61-3.21; P<.001>
    • Type 2 diabetes: aHR, 1.30; 95% CI, 1.07-1.57; P=.009; and
    • Hypertension: aHR, 1.55; 95% CI, 1.30-1.84; P<.001.>
  • The incidence of IIH increased from 2.5 to 9.3 per 100,000 person-years between 2005 and 2017.
  • During the same period, the prevalence of IIH increased from 26 to 79 per 100,000 women.

Limitations

  • Risk for bias.