Stroke, Vol 17, 1078-1083, Copyright © 1986 by American Heart Association
T Brott, K Thalinger and V Hertzberg
To better define the etiologic importance of hypertension for spontaneous
intracerebral hemorrhage, hospital records were studied for all patients
sustaining intracerebral hemorrhage during 1982 in the Cincinnati
metropolitan area. Hypertension pre-dating the hemorrhage was present in
45% (69 of 154), as determined by history. A more inclusive definition of
hypertension, combining those with a positive history with those found to
have left ventricular hypertrophy by electrocardiogram or cardiomegaly by
chest radiography, applied in 56% (87 of 154). The cases were compared to
controls with and without hypertension derived from the NHANES II study of
blood pressure (n = 16,204) to determine relative risk. For the presence of
hypertension by history, the relative risk of intracerebral hemorrhage was
3.9 (95% confidence interval, 2.7 to 5.7). For the inclusive definition of
hypertension, the relative risk was 5.4 (3.7 to 7.9). Relative risk was
also determined for hypertension in blacks (= 4.4), age greater than 70 (=
7), prior cerebral infarction (= 22), and diabetes (= 3). We conclude that
the term "hypertensive hemorrhage" should be used very selectively,
particularly in whites, and propose that hypertension be viewed as one of
several important risk factors for spontaneous intracerebral hemorrhage.
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Hypertension as a risk factor for spontaneous intracerebral hemorrhage
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