Association Between Idiopathic Intracranial Hypertension and Risk of Cardiovascular Diseases in Women in the United Kingdom

Abstract

Key PointsQuestionIs the risk of cardiovascular disease greater in women with idiopathic intracranial hypertension than in women of the same age and body mass index but without idiopathic intracranial hypertension?FindingsIn this population-based matched controlled cohort study of 2760 female patients with idiopathic intracranial hypertension and 27 125 control patients, women with this condition had twice the risk for cardiovascular disease compared with their counterparts with similar body mass index and age. Between 2005 and 2017, the incidence and prevalence of idiopathic intracranial hypertension have tripled.MeaningIdiopathic intracranial hypertension appeared to be a risk factor for cardiovascular disease in women; changing patient management to address the risk factors for cardiovascular disease may reduce long-term morbidity.

11βHSD1 Inhibition with AZD4017 Improves Lipid Profiles and Lean Muscle Mass in Idiopathic Intracranial Hypertension

“…Consequently, in addition to the direct inhibition of 11β-HSD1 activity and CSF production in the choroid plexus of IIH patients, as proposed by Sinclair et al, secondary improvements in IIH risk factors such as lipid metabolism and obesity may also be realized in patients receiving AZD4017, offering further therapeutic efficacy ( 15 , 18 , 19 ). Particularly, given the increased incidence of adverse cardiovascular outcomes reported in IIH patients relative to matched controls, AZD4017 may prove an effective adjunct in IIH to reduce cardiovascular risk ( 43 ).…”

<p>Exploring The Current Management Idiopathic Intracranial Hypertension, And Understanding The Role Of Dural Venous Sinus Stenting</p>

“…Our knowledge of IIH is advancing rapidly and a modern approach to the disease entity is emerging. 7,9,86 Interventions for those who have precipitous visual loss needs to be investigated in a systematic way to provide a high level of confidence that vision will be preserved or improved. It seems apparent that venous sinus stenting does have a role in the management of IIH.…”

“…8 Intriguingly, women with IIH appear to have a 2-fold increase in the cardiovascular disease risk, over and above age, gender and BMI matched controls, providing further evidence that this may well be a neurometabolic disease. 9 The clinical presentation varies but symptoms classically include headache; however, our understanding of the traditional phenotype of raised ICP headache has progressed and often those with IIH have headaches that fulfil the criteria for migraine. 10,11 Other common symptoms include pulse synchronous tinnitus, transient visual obscurations, double vision (from unilateral or bilateral 6th nerve palsy), reduction in visual acuity or visual field, and neck pain 1,12 Previously termed as benign intracranial hypertension, IIH was renamed to reflect the fact that the condition may be associated with severe morbidity, most commonly permanent visual loss, affecting up to 24% of patients in early studies 13 and a reduced quality of life which is linked to headache morbidity.…”

Idiopathic intracranial hypertension: Update on diagnosis and management

“…Patients with IIH have double the normal risk of cardiovascular disease and therefore modifiable risk factors (eg cessation of smoking) should be addressed early. 5 Patients with IIH occasionally deteriorate or relapse, especially following rapid weight gain. Therefore, patients need help to find long-term solutions for maintenance of weight loss.…”

“…3,4 IIH patients also have double the normal cardiovascular risk, independent of obesity. 1,5 In most patients, ICP can be controlled with weight loss and with drugs that reduce cerebrospinal fluid (CSF) production. [6][7][8] In some patients, CSF divergence surgery or optic nerve sheath fenestration is necessary to prevent permanent visual loss.…”