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Risk factors for intracerebral haemorrhage – Results from a prospective population-based study

Svensson, Edith H. LU orcid ; Abul-Kasim, Kasim LU ; Engström, Gunnar LU and Söderholm, Martin LU (2020) In European Stroke Journal 5(3). p.278-285
Abstract

Introduction: While the relationship between hypertension and incident intracerebral haemorrhage is well established, other risk factors are less clear. This study examined risk factors for primary intracerebral haemorrhage, separately for lobar and non-lobar intracerebral haemorrhage. Patients and methods: Incidence of intracerebral haemorrhage was studied among 28,416 individuals from the population-based Malmö Diet and Cancer cohort. Intracerebral haemorrhage cases were ascertained using the Swedish Hospital Discharge Register and the Stroke Register of Malmö, validated by review of hospital records and images, and classified by location by a neuroradiologist. Multivariable Cox regression was used. Results: Three hundred and... (More)

Introduction: While the relationship between hypertension and incident intracerebral haemorrhage is well established, other risk factors are less clear. This study examined risk factors for primary intracerebral haemorrhage, separately for lobar and non-lobar intracerebral haemorrhage. Patients and methods: Incidence of intracerebral haemorrhage was studied among 28,416 individuals from the population-based Malmö Diet and Cancer cohort. Intracerebral haemorrhage cases were ascertained using the Swedish Hospital Discharge Register and the Stroke Register of Malmö, validated by review of hospital records and images, and classified by location by a neuroradiologist. Multivariable Cox regression was used. Results: Three hundred and thirty-three intracerebral haemorrhages occurred, mean follow-up time was 18.4 years. Systolic blood pressure (hazard ratio per 10 mmHg 1.19 [95% confidence interval 1.13–1.26], diastolic blood pressure (hazard ratio 1.42 [1.27–1.59]), oral anticoagulants (hazard ratio 4.26 [2.17–8.38]), smoking (hazard ratio 1.45 [1.14–1.87]), living alone (hazard ratio 1.32 [1.04–1.69]) and low apolipoprotein B (hazard ratio per 10 mg/dL: 0.94 [0.90–0.99]) were significantly associated with incident intracerebral haemorrhage after multivariable adjustment. Systolic blood pressure, smoking and oral anticoagulants were associated with lobar intracerebral haemorrhage. Systolic blood pressure, diastolic blood pressure, living alone and diabetes were associated with non-lobar intracerebral haemorrhage. Diabetes and diastolic blood pressure showed significantly different relationships with lobar and non-lobar intracerebral haemorrhage. Alcohol, apolipoprotein A1, body mass index, waist circumference, physical activity and education were not independently associated with intracerebral haemorrhage. Discussion and conclusions: Blood pressure, smoking, low apolipoprotein B, oral anticoagulants and living alone were associated with intracerebral haemorrhage. Diabetes was associated with non-lobar intracerebral haemorrhage only. Further research is required on differences between lobar and non-lobar intracerebral haemorrhage.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, Intracerebral haemorrhage, intracranial haemorrhage, risk factors, stroke
in
European Stroke Journal
volume
5
issue
3
pages
8 pages
publisher
SAGE Publications
external identifiers
  • scopus:85086316968
  • pmid:33072882
ISSN
2396-9873
DOI
10.1177/2396987320932069
language
English
LU publication?
yes
id
31231403-ed31-4ed9-9197-52031c974ae9
date added to LUP
2021-01-14 11:01:04
date last changed
2024-06-13 05:23:25
@article{31231403-ed31-4ed9-9197-52031c974ae9,
  abstract     = {{<p>Introduction: While the relationship between hypertension and incident intracerebral haemorrhage is well established, other risk factors are less clear. This study examined risk factors for primary intracerebral haemorrhage, separately for lobar and non-lobar intracerebral haemorrhage. Patients and methods: Incidence of intracerebral haemorrhage was studied among 28,416 individuals from the population-based Malmö Diet and Cancer cohort. Intracerebral haemorrhage cases were ascertained using the Swedish Hospital Discharge Register and the Stroke Register of Malmö, validated by review of hospital records and images, and classified by location by a neuroradiologist. Multivariable Cox regression was used. Results: Three hundred and thirty-three intracerebral haemorrhages occurred, mean follow-up time was 18.4 years. Systolic blood pressure (hazard ratio per 10 mmHg 1.19 [95% confidence interval 1.13–1.26], diastolic blood pressure (hazard ratio 1.42 [1.27–1.59]), oral anticoagulants (hazard ratio 4.26 [2.17–8.38]), smoking (hazard ratio 1.45 [1.14–1.87]), living alone (hazard ratio 1.32 [1.04–1.69]) and low apolipoprotein B (hazard ratio per 10 mg/dL: 0.94 [0.90–0.99]) were significantly associated with incident intracerebral haemorrhage after multivariable adjustment. Systolic blood pressure, smoking and oral anticoagulants were associated with lobar intracerebral haemorrhage. Systolic blood pressure, diastolic blood pressure, living alone and diabetes were associated with non-lobar intracerebral haemorrhage. Diabetes and diastolic blood pressure showed significantly different relationships with lobar and non-lobar intracerebral haemorrhage. Alcohol, apolipoprotein A1, body mass index, waist circumference, physical activity and education were not independently associated with intracerebral haemorrhage. Discussion and conclusions: Blood pressure, smoking, low apolipoprotein B, oral anticoagulants and living alone were associated with intracerebral haemorrhage. Diabetes was associated with non-lobar intracerebral haemorrhage only. Further research is required on differences between lobar and non-lobar intracerebral haemorrhage.</p>}},
  author       = {{Svensson, Edith H. and Abul-Kasim, Kasim and Engström, Gunnar and Söderholm, Martin}},
  issn         = {{2396-9873}},
  keywords     = {{epidemiology; Intracerebral haemorrhage; intracranial haemorrhage; risk factors; stroke}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{3}},
  pages        = {{278--285}},
  publisher    = {{SAGE Publications}},
  series       = {{European Stroke Journal}},
  title        = {{Risk factors for intracerebral haemorrhage – Results from a prospective population-based study}},
  url          = {{http://dx.doi.org/10.1177/2396987320932069}},
  doi          = {{10.1177/2396987320932069}},
  volume       = {{5}},
  year         = {{2020}},
}