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Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
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2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, article id dyz163Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.

METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.

RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.

CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.

Place, publisher, year, edition, pages
2019. article id dyz163
Keywords [en]
Stroke, cohort study, epidemiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-162427DOI: 10.1093/ije/dyz163PubMedID: 31363756OAI: oai:DiVA.org:umu-162427DiVA, id: diva2:1344210
Note

2019-08-22: Epub ahead of print. Granskad. /LiL

Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-22Bibliographically approved

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Söderberg, StefanAndersson, MartinEriksson, MarieForsberg, BertilJärvholm, BengtPennlert, Johanna

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Söderberg, StefanAndersson, MartinEriksson, MarieForsberg, BertilJärvholm, BengtPennlert, Johanna
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Department of Public Health and Clinical MedicineSection of Sustainable HealthStatistics
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International Journal of Epidemiology
Public Health, Global Health, Social Medicine and Epidemiology

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