Racial differences between Maori and European New Zealanders in aneurysmal subarachnoid haemorrhage

Area of Science:

• Neurology
• Epidemiology
• Vascular Surgery

Background:

• Racial disparities in intracranial aneurysm (IA) incidence and rupture rates are documented.
• Understanding these differences is crucial for targeted public health interventions and clinical management.

Purpose of the Study:

• To investigate and compare the incidence, clinical presentation, and risk factors of intracranial aneurysms between Maori and European New Zealanders.
• To identify specific aneurysm locations and their association with racial groups.

Main Methods:

• Retrospective cohort study analyzing data from the Auckland Regional Neurosurgical Unit (1985-1990).
• Inclusion criteria: Maori and European patients presenting with intracranial aneurysms.
• Data collected on incidence, age at rupture, aneurysm location, and smoking status.

Main Results:

• Maori population showed a significantly higher incidence of IA (25.7 per 100,000) compared to Europeans (14.3 per 100,000).
• Maori patients experienced aneurysm rupture approximately 10 years earlier than European patients, particularly with single aneurysms.
• A strong association between cigarette smoking and aneurysmal subarachnoid hemorrhage (aSAH) was observed in both racial groups.
• Maori individuals had a higher prevalence of middle cerebral artery aneurysms and a lower prevalence of vertebrobasilar aneurysms compared to Europeans.

Conclusions:

• Significant racial differences exist in the epidemiology and clinical characteristics of intracranial aneurysms between Maori and European New Zealanders.
• Cigarette smoking is a critical, modifiable risk factor for aSAH across both populations.
• Further research into the underlying genetic and environmental factors contributing to these disparities is warranted.