Smoking and aneurysmal subarachnoid haemorrhage: a case-control study.
BACKGROUND
Despite recent advances in the management of subarachnoid haemorrhage, the mortality rate associated with the condition remains high. The identification of risk factors for subarachnoid haemorrhage may lead to the development of interventions aimed at its prevention.


METHODS
We compared the prevalence of vascular risk factors using a case-control design in 141 consecutively admitted patients who had suffered a subarachnoid haemorrhage with that in age- and sex-matched subjects registered with a general practitioner in a western suburb of Lisbon.


RESULTS
The prevalence of diabetes and hyperlipidaemia did not differ between the groups. Hypertension was 8.3 times more frequent among patients with subarachnoid haemorrhage (95% confidence interval 4.6-16.7) than in the control group, and smoking was four times more frequent (95% confidence interval 2.0-8.6). The association between smoking and subarachnoid haemorrhage persisted after controlling for the presence of hypertension (odds ratio for hypertensive participants = 10.5, 95% confidence interval 1.9-56.4; odds ratio for normotensive participants = 3.7, 95% confidence interval 1.6-10.1) and was independent of both age and sex.


CONCLUSIONS
These results indicate that hypertension and smoking are both involved in the growth or rupture of cerebral aneurysms.
Canhão
P
P
Department of Neurology, Hospital Santa Maria, Lisbon, Portugal.
Pinto
A N
AN
Ferro
H
H
Ferro
J M
JM
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000209:etiology*