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Risk factors for spontaneous intracerebral hemorrhage
S Juvela1, M Hillbom, H Palomäki
1Department of Neurosurgery, Helsinki University Central Hospital, Finland.
Insights
Recent moderate to heavy alcohol consumption, hypertension, and anticoagulant treatment are significant modifiable risk factors for intracerebral hemorrhage. Identifying these factors can aid in preventing this serious neurological condition.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Spontaneous intracerebral hemorrhage (ICH) remains a significant cause of morbidity and mortality.
- Despite advances in medical care, identifying modifiable risk factors for ICH is crucial for prevention.
Purpose of the Study:
- To investigate modifiable risk factors associated with intracerebral hemorrhage.
- To provide insights for the prevention of spontaneous ICH.
Main Methods:
- A case-control study comparing 156 ICH patients (aged 16-60) with 332 hospitalized controls.
- Data collected included health habits, past diseases, and medication use.
- Statistical analysis adjusted for sex, age, hypertension, BMI, smoking, and alcohol consumption.
Main Results:
- Recent alcohol intake within 24 hours and 1 week prior to onset significantly increased ICH risk, with dose-dependent effects.
- Hypertension was a major independent risk factor (adjusted risk ratio 6.6).
- Anticoagulant treatment was also identified as a significant risk factor (P < .01).
Conclusions:
- Recent moderate to heavy alcohol consumption, hypertension, and anticoagulant therapy are likely independent risk factors for ICH.
- These findings highlight key targets for preventative strategies against intracerebral hemorrhage.
Background And Purpose:
Spontaneous intracerebral hemorrhage has remained a serious disease despite recent improvements in medical treatment. This study was designed to identify modifiable risk factors for intracerebral hemorrhage.
Methods:
Health habits, previous diseases, and medication of 156 consecutive patients with intracerebral hemorrhage aged 16 to 60 years (96 men and 60 women) were compared with those of 332 hospitalized control patients (192 men and 140 women) who did not differ from case subjects in respect to age, day of onset of symptoms, or acuteness of disease onset.
Results:
After adjustment for sex, age, hypertension, body mass index, smoking status, and alcohol consumption during the last week, patients who had consumed 1 to 40, 41 to 120, or > 120 g of alcohol within the 24 hours preceding the onset of illness had a relative risk (95% confidence interval) of hemorrhage of 0.3 (0.2 to 0.7), 4.6 (2.2 to 9.4), and 11.3 (3.0 to 42.8), respectively, compared with those who had consumed 0 g. In addition, alcohol intake within 1 week before the onset of illness, excluding use within the last 24 hours, increased the risk of hemorrhage; adjusted risks were 2.0 (1.1 to 3.5) for 1 to 150 g, 4.3 (1.6 to 11.7) for 151 to 300 g, and 6.5 (2.4 to 17.7) for > 300 g compared with 0 g. The adjusted risk of hypertension for hemorrhage was 6.6 (3.9 to 11.3). Previous heavy alcohol consumption and current cigarette smoking were not independent risk factors for hemorrhage, but anticoagulant treatment was (P < .01). Erythrocyte mean corpuscular volume and gamma-glutamyl transferase values were also higher in patients with intracerebral hemorrhage than in control subjects.
Conclusions:
Recent moderate and heavy alcohol intake as well as hypertension and likely also anticoagulant treatment seem to be independent risk factors for intracerebral hemorrhage.