The relationships of gender, cigarette smoking, and hypertension with the risk of aneurysmal subarachnoid hemorrhage: a case-control study in Nagoya, Japan.
OBJECTIVE
To examine the relationship of gender, cigarette smoking, and a history of hypertension to the risk of aneurysmal subarachnoid hemorrhage (SAH), using a case-control study.


METHODS
Case subjects consisted of a consecutive series of 201 patients with spontaneous SAH with aneurysm(s) confirmed by angiography and/or CT scan. One hospital and one community control subject was matched to each case by gender and age (+/- 2 years). Multiple conditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) adjusted for potential confounders.


RESULTS
Current smoking and a history of hypertension were each significantly associated with an increased risk of subarachnoid hemorrhage for men and women combined. There was also a non-significant trend towards synergism between these two factors with respect to an increased risk of subarachnoid hemorrhage for each gender separately and both combined. A significantly increased risk was observed for a history of hypertension (adjusted OR, 3.5; 95% CI, 1.2-14.7) among men, for current smoking alone (adjusted OR, 2.9; 95% CI, 1.1-7.7), and a history of hypertension alone (adjusted OR, 2.6; 95% CI, 1.4-5.1) among women.


CONCLUSIONS
Trends towards gender differences and synergism emerged in the relationship of cigarette smoking and a history of hypertension of the risk of SAH provides useful information for targeting individuals/populations in programs for the primary prevention of SAH by gender.
Okamoto
Kazushi
K
Department of Public Health, Aichi Prefectural College of Nursing and Health, Kamishidami, Nagoya, Japan. okamoto@aichi-nurs.ac.jp
Horisawa
Rokuro
R
Ohno
Yoshiyuki
Y
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D002532:Intracranial Aneurysm / Q000150:complications / Q000209:etiology*; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D013345:Subarachnoid Hemorrhage / Q000209:etiology*