Published online before print June 2, 2005, doi: 10.1161/01.STR.0000170710.95689.41
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2005;36:1360.)
© 2005 American Heart Association, Inc.
Original Contributions |
Smoking and Elevated Blood Pressure Are the Most Important Risk Factors for Subarachnoid Hemorrhage in the Asia-Pacific Region
An Overview of 26 Cohorts Involving 306 620 Participants
From the Clinical Trials Research Unit (V.F., V.P., C.M.M.L., A.R.), Department of Medicine and School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; the Department of Preventive Medicine (I.S.), Yonsei University College of Medicine, Seoul, Korea; The George Institute for International Health (M.W.), University of Sydney, Australia; the School of Population Health (K.J.), University of Queensland, Herston, Australia; and the Department of Health Science (H.U.), Shiga University of Medical Science, Shiga, Japan.
Correspondence to Valery Feigin, Clinical Trials Research Unit, Faculty of Medicine and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail v.feigin{at}ctru.auckland.ac.nz
Background and Purpose— The cause of subarachnoid hemorrhage (SAH) is poorly understood and there are few large cohort studies of risk factors for SAH. We investigated the risk of SAH mortality and morbidity associated with common cardiovascular risk factors in the Asia-Pacific region and examined whether the strengths of these associations were different in Asian and Australasian (predominantly white) populations.
Methods— Cohort studies were identified from Internet electronic databases, searches of proceedings of meetings, and personal communication. Hazard ratios (HRs) for systolic blood pressure (SBP), current smoking, total serum cholesterol, body mass index (BMI), and alcohol drinking were calculated from Cox models that were stratified by sex and cohort and adjusted for age at risk.
Results— Individual participant data from 26 prospective cohort studies (total number of participants 306 620) that reported incident cases of SAH (fatal and/or nonfatal) were available for analysis. During the median follow-up period of 8.2 years, a total of 236 incident cases of SAH were observed. Current smoking (HR, 2.4; 95% CI, 1.8 to 3.4) and SBP >140 mm Hg (HR, 2.0; 95% CI, 1.5 to 2.7) were significant and independent risk factors for SAH. Attributable risks of SAH associated with current smoking and elevated SBP (
140 mm Hg) were 29% and 19%, respectively. There were no significant associations between the risk of SAH and cholesterol, BMI, or drinking alcohol. The strength of the associations of the common cardiovascular risk factors with the risk of SAH did not differ much between Asian and Australasian regions.
Conclusions— Cigarette smoking and SBP are the most important risk factors for SAH in the Asia-Pacific region.
Key Words: meta-analysis • risk factors • subarachnoid hemorrhage
This article has been cited by other articles:
 |
|
 |
|
  M. S. Sandvei, P. R. Romundstad, T. B. Muller, L. Vatten, and A. Vik Risk Factors for Aneurysmal Subarachnoid Hemorrhage in a Prospective Population Study: The HUNT Study in Norway Stroke, June 1, 2009; 40(6): 1958 - 1962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Feigin and M. Findlay Advances in Subarachnoid Hemorrhage Stroke, February 1, 2006; 37(2): 305 - 308. [Full Text] [PDF]
|
|
|
|
 |
|
 Other articles noted Evid. Based Med., December 1, 2005; 10(6): 191 - 192. [Full Text] [PDF]
|
|
|
|
 |
|
 Minerva BMJ, July 30, 2005; 331(7511): 300 - 300. [Full Text] [PDF]
|
|