(Stroke. 2001;32:1173.)
© 2001 American Heart Association, Inc.
Original Contributions |
Attributable Risk of Common and Rare Determinants of Subarachnoid Hemorrhage
From the Department of Neurology (Y.M.R., G.J.E.R.) and Julius Center for General Practice and Patient Oriented Research (E.B.), University Medical Center Utrecht (Netherlands).
Correspondence to Y.M. Ruigrok, MD, Department of Neurology, University Medical Center Utrecht, PO Box 85500, 3500 GA Utrecht, Netherlands. E-mail ij.m.ruigrok{at}neuro.azu.nl
Background and Purpose—Smoking, hypertension, alcohol consumption, autosomal dominant polycystic kidney disease (ADPKD), and positive family history for subarachnoid hemorrhage (SAH) are well-known risk factors for SAH. For effective prevention, knowledge about the contribution of these risk factors to the overall occurrence of SAH in the general population is pivotal. We therefore investigated the population attributable risks of the risk factors for SAH.
Methods—We retrieved the relative risk and prevalence of established risk factors for SAH from the literature and calculated the population attributable risks of these risk factors.
Results—Drinking
alcohol 100 to 299 g/wk accounted for 11% of the cases of SAH,
drinking alcohol 
300 g/wk accounted for 21%, and smoking accounted
for 20%. An additional 17% of the cases could be attributed to
hypertension, 11% to a positive family history for SAH, and 0.3% to
ADPKD.
Conclusions—Screening and preventive treatment of patients with familial preponderance of SAH alone will cause a modest reduction of the incidence of SAH in the general population. Further reduction can be achieved by reducing the prevalence of the modifiable risk factors alcohol consumption, smoking, and hypertension.
Key Words: epidemiology • risk factors • subarachnoid hemorrhage
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