Abstract | BACKGROUND AND PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS:
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Authors | Valery L Feigin, Gabriel J E Rinkel, Carlene M M Lawes, Ale Algra, Derrick A Bennett, Jan van Gijn, Craig S Anderson |
Journal | Stroke
(Stroke)
Vol. 36
Issue 12
Pg. 2773-80
(Dec 2005)
ISSN: 1524-4628 [Electronic] United States |
PMID | 16282541
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Topics |
- Age of Onset
- Alcoholism
(epidemiology)
- Body Mass Index
- Case-Control Studies
- Comorbidity
- Diabetes Mellitus
(epidemiology)
- Female
- Humans
- Hypercholesterolemia
(epidemiology)
- Hypertension
(epidemiology)
- Longitudinal Studies
- Male
- Risk Factors
- Smoking
(epidemiology)
- Subarachnoid Hemorrhage
(epidemiology)
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