Risk Factors for Subarachnoid Hemorrhage

  • Valery L. Feigin
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...
  • Gabriel J.E. Rinkel
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...
  • Carlene M.M. Lawes
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...
  • Ale Algra
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...
  • Derrick A. Bennett
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...
  • Jan van Gijn
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...
  • Craig S. Anderson
    From the Clinical Trials Research Unit (V.L.F., C.M.M.L.), Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Department of Neurology (G.J.E.R., A.A., J.v.G.), University Hospital Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care University Department (A.A.), University Medical Center Utrecht, The Netherlands; Clinical Trials Service Unit and Epidemiological Studies Unit (D.A.B.), Nuffield Department of Clinical Medicine, University of...

Bibliographic Information

Other Title
  • An Updated Systematic Review of Epidemiological Studies

Description

<jats:p> <jats:bold> <jats:italic>Background and Purpose—</jats:italic> </jats:bold> After a 1996 review from our group on risk factors for subarachnoid hemorrhage (SAH), much new information has become available. This article provides an updated overview of risk factors for SAH. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods—</jats:italic> </jats:bold> An overview of all longitudinal and case-control studies of risk factors for SAH published in English from 1966 through March 2005. We calculated pooled relative risks (RRs) for longitudinal studies and odds ratios (ORs) for case-control studies, both with corresponding 95% CIs. </jats:p> <jats:p> <jats:bold> <jats:italic>Results—</jats:italic> </jats:bold> We included 14 longitudinal (5 new) and 23 (12 new) case-control studies. Overall, the studies included 3936 patients with SAH (892 cases in 14 longitudinal studies and 3044 cases in 23 case-control studies) for analysis. Statistically significant risk factors in longitudinal and case-control studies were current smoking (RR, 2.2 [1.3 to 3.6]; OR, 3.1 [2.7 to 3.5]), hypertension (RR, 2.5 [2.0 to 3.1]; OR, 2.6 [2.0 to 3.1]), and excessive alcohol intake (RR, 2.1 [1.5 to 2.8]; OR, 1.5 [1.3 to 1.8]). Nonwhite ethnicity was a less robust risk factor (RR, 1.8 [0.8 to 4.2]; OR, 3.4 [1.0 to 11.9]). Oral contraceptives did not affect the risk (RR, 5.4 [0.7 to 43.5]; OR, 0.8 [0.5 to 1.3]). Risk reductions were found for hormone replacement therapy (RR, 0.6 [0.2 to 1.5]; OR, 0.6 [0.4 to 0.8]), hypercholesterolemia (RR, 0.8 [0.6 to 1.2]; OR, 0.6 [0.4 to 0.9]), and diabetes (RR, 0.3 [0 to 2.2]; OR, 0.7 [0.5 to 0.8]). Data were inconsistent for lean body mass index (RR, 0.3 [0.2 to 0.4]; OR, 1.4 [1.0 to 2.0]) and rigorous exercise (RR, 0.5 [0.3 to 1.0]; OR, 1.2 [1.0 to 1.6]). In the studies included in the review, no other risk factors were available for the meta-analysis. </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Smoking, hypertension, and excessive alcohol remain the most important risk factors for SAH. The seemingly protective effects of white ethnicity compared to nonwhite ethnicity, hormone replacement therapy, hypercholesterolemia, and diabetes in the etiology of SAH are uncertain. </jats:p>

Journal

  • Stroke

    Stroke 36 (12), 2773-2780, 2005-12

    Ovid Technologies (Wolters Kluwer Health)

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