Published Online
on August 30, 2007

A more recent version of this article appeared on October 1, 2007

This Article Full Text (PDF) All Versions of this Article: 38/10/2718    most recent STROKEAHA.107.487090v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sturgeon, J. D. Articles by Cushman, M. Search for Related Content PubMed PubMed Citation Articles by Sturgeon, J. D. Articles by Cushman, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Stroke Related Collections Cerebrovascular disease/stroke Risk Factors Acute Cerebral Hemorrhage Epidemiology

Submitted on March 5, 2007
Revised on March 29, 2007
Accepted on April 4, 2007

Risk Factors for Intracerebral Hemorrhage in a Pooled Prospective Study

Jared D. Sturgeon PhD; Aaron R. Folsom MD, MPH^*; W. T. Longstreth Jr MD, MPH; Eyal Shahar MD, MPH; Wayne D. Rosamond PhD; and Mary Cushman MD, MSc

From the Division of Epidemiology & Community Health (J.D.S., A.R.F.), School of Public Health, University of Minnesota, Minneapolis; the Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; the Division of Epidemiology and Biostatistics (E.S.), University of Arizona, Tucson; the Department of Epidemiology (W.D.R.), University of North Carolina, Chapel Hill; the Departments of Medicine and Pathology (M.C.), University of Vermont, Burlington.

^* To whom correspondence should be addressed. E-mail: folsom{at}epi.umn.edu.

Background and Purpose—Few prospective studies have reported risk factors for intracerebral hemorrhage (ICH), and results are inconsistent. We studied risk factors for ICH in a pooled cohort of the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS).

Methods—The ARIC cohort was recruited in 1987 to 1989 and involves 15 792 men and women, aged 45 to 64 years at baseline, sampled from 4 US communities. The CHS cohort was recruited in 1989 to 1993 and involves 5888 men and women, aged 65 or over at baseline, sampled from 4 US communities. Baseline measurements included many potential vascular risk factors. The cohorts were followed for incident stroke events.

Results—Over 263 489 person-years of follow-up, 135 incident ICH events occurred. In a multivariable model, age, African-American ethnicity (versus Whites), and hypertension were positively associated with incident ICH, whereas low-density lipoprotein cholesterol and triglycerides were inversely related to incident ICH. Participants with systolic blood pressure 160 mm Hg or diastolic blood pressure 110 mm Hg had 5.55 (95% CI 3.07 to 10.0) times the rate of ICH as nonhypertensives. Sex, smoking, alcohol intake, body mass index, waist-to-hip ratio, waist circumference, and diabetes were not related to ICH.

Conclusions—In this pooled cohort the risk factors for ICH were older age, African-American ethnicity, hypertension, lower LDL-C, and lower triglycerides.

Key words: cerebral hemorrhage • epidemiology • hypertension • risk factors • stroke

This article has been cited by other articles:

				S.-W. Yi, N. Odongua, C. M. Nam, J. W. Sull, and H. Ohrr Body Mass Index and Stroke Mortality by Smoking and Age at Menopause Among Korean Postmenopausal Women Stroke, November 1, 2009; 40(11): 3428 - 3435. [Abstract] [Full Text] [PDF]

				K. Karki, R. A. Knight, Y. Han, D. Yang, J. Zhang, K. A. Ledbetter, M. Chopp, and D. M. Seyfried Simvastatin and Atorvastatin Improve Neurological Outcome After Experimental Intracerebral Hemorrhage Stroke, October 1, 2009; 40(10): 3384 - 3389. [Abstract] [Full Text] [PDF]

				E. E. Smith, L. Liang, A. Hernandez, M. J. Reeves, C. P. Cannon, G. C. Fonarow, and L. H. Schwamm Influence of stroke subtype on quality of care in the Get With The Guidelines-Stroke Program Neurology, September 1, 2009; 73(9): 709 - 716. [Abstract] [Full Text] [PDF]

				D. Summers, A. Leonard, D. Wentworth, J. L. Saver, J. Simpson, J. A. Spilker, N. Hock, E. Miller, P. H. Mitchell, and on behalf of the American Heart Association Counci Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient: A Scientific Statement From the American Heart Association Stroke, August 1, 2009; 40(8): 2911 - 2944. [Full Text] [PDF]

				K. K. Andersen, T. S. Olsen, C. Dehlendorff, and L. P. Kammersgaard Hemorrhagic and Ischemic Strokes Compared: Stroke Severity, Mortality, and Risk Factors Stroke, June 1, 2009; 40(6): 2068 - 2072. [Abstract] [Full Text] [PDF]

				L. B. Goldstein The Complex Relationship Between Cholesterol and Brain Hemorrhage Circulation, April 28, 2009; 119(16): 2131 - 2133. [Full Text] [PDF]

				J. D. Sturgeon, A. R. Folsom, W.T. Longstreth Jr, E. Shahar, W. D. Rosamond, and M. Cushman Hemostatic and Inflammatory Risk Factors for Intracerebral Hemorrhage in a Pooled Cohort Stroke, August 1, 2008; 39(8): 2268 - 2273. [Abstract] [Full Text] [PDF]

				L. Mascitelli, F. Pezzetta, J. Castillo, M. Blanco, A. Davalos, and S. de Compostela STATIN TREATMENT WITHDRAWAL IN ISCHEMIC STROKE: A CONTROLLED RANDOMIZED STUDY Neurology, May 6, 2008; 70(19): 1720 - 1721. [Full Text] [PDF]

				G. Howard and V. Feigin Advances in Population Studies 2007 Stroke, February 1, 2008; 39(2): 283 - 285. [Full Text] [PDF]