Prevalence of cardiovascular and cerebrovascular disease in idiopathic intracranial hypertension

Abstract

Background and objectives

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.

Methods

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/m²). 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.

Results

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).

Discussion

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.