Cohort Study on Risk Factors for Subarachnoid Hemorrhage among Japanese Men and Women.

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  • SANKAI Tomoko
    Department of Community Medicine, University of Tsukuba
  • ISO Hiroyasu
    Department of Community Medicine, University of Tsukuba
  • SHIMAMOTO Takashi
    Department of Community Medicine, University of Tsukuba
  • KITAMURA Akihiko
    Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Disease
  • NAITO Yoshihiko
    Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Disease
  • SATO Shinichi
    Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Disease
  • OKAMURA Tomonori
    Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Disease
  • IMANO Hironori
    Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Disease
  • IIDA Minoru
    Department of Epidemiology and Mass Examination for Cardiovascular Diseases, Osaka Medical Center for Cancer and Cardiovascular Disease
  • KOMACHI Yoshio
    The Osaka Prefectural Institute of Public Health

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Other Title
  • わが国におけるくも膜下出血の危険因子に関するコホート研究
  • ワガクニ ニ オケル ク モ マク カ シュッケツ ノ キケン インシ ニ カンスル コホート ケンキュウ

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Abstract

Purpose: To examine the risk factors for subarachnoid hemorrhage, for few prospective data have been available on risk factors of subarachnoid hemorrhage among Japanese.<br>Methods: A 9.4-year cohort study was conducted on 12, 372 men and women, aged 40-69 years, free of history of stroke in six communities in Japan.<br>Results: During the follow-up, seventy-one incidents of subarachnoid hemorrhage occurred. After adjusting for age, serum total cholesterol, body mass index, history of diabetes mellitus, blood pressure category and drinking category, current smokers had a significantly increased risk of subarachnoid hemorrhage compared with ‘never-smokers’: multivariate relative risk (RR) [95% confidence interval (95%CI)]=3.1(1.4-6.9) for women, 1.5(0.4-5.3) for men and 2.7(1.3-5.5) for men and women. Hypertensives had a significantly increased risk of subarachnoid hemorrhage compared with normotensives: multivariate RR(95%CI)=3.1(1.6-6.0) for women, 4.3(1.5-12.0) for men and 3.4(2.0-5.9) for men and women. For men, heavy drinkers (>=69g per day ethanol), had a significantly increased risk of subarachnoid hemorrhage compared with ‘never-drinkers’: multivariate RR(95%CI)=4.3(1.1-16.8). For women, the relationship between heavy drinking and risk was not examined due to the small number of heavy drinkers (n=13). Multivariate RR(95%CI) for men who smoked currently and drank heavily compared with men who did not smoke currently nor drink heavily was 6.0(1.8-20.1). Multivariate RR(95%CI) for hypertensive men who drank heavily compared with normotensive or borderline hypertensive men who did not drink heavily was 13.0(3.9-43.9). Multivariate RR(95%CI) for hypertensive men and women who smoked currently compared with normotensive or borderline hypertensive men and women who did not smoke currently was 6.1(1.3-28.7) for men and 6.3(1.4-28.0) for women. Furthermore, the combination of smoking, hypertension and heavy drinking raised the risk of subarachnoid hemorrhage substantially: multivariate RR(95%CI)=17.5(3.4-90.2).<br>Conclusion: Smoking and hypertension appeared to increase the risk of subarachnoid hemorrhage. For men, although the association of smoking with the risk of subarachnoid hemorrhage was weak compared with women, the combination of smoking, hypertension and heavy drinking increased the risk substantially. For women, smoking appeared to be an independent risk of subarachnoid hemorrhage, and the combination of smoking and hypertension increased the risk in additive fashion.

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