Risk factors for primary intracerebral hemorrhage: a population-based nested case-control study.
OBJECTIVE
In this population-based study, risk factors for primary intracerebral hemorrhage (PICH) and PICH subtypes were explored in a nested case-control design.


METHODS
Risk factors were determined in 22,444 men and 10,902 women (mean age 47 years) who participated in a health-screening programme between 1974 and 1991. 147 subjects with CT or autopsy-verified first-ever PICH during the follow-up period (mean 14 years) were compared with 1,029 stroke-free controls, matched for age, sex and screening-year.


RESULTS
As compared to controls, PICH cases had significantly higher blood pressure (135/91 vs. 127/85 mm Hg), triglycerides (1.7 vs. 1.4 mmol/l), BMI (25.5 vs. 24.8) and shorter stature (1.73 vs. 1.74 m). Diabetes (6.9 vs. 2.8 %) and history of psychiatric morbidity (19.7 vs. 11.0 %) were more common in PICH cases and more of them were living alone (35.4 vs. 25.5%). After adjustment in a backward logistic regression model, high systolic blood pressure, diabetes, high triglycerides, short stature and psychiatric morbidity remained significantly associated with PICH. As compared to the control group, high systolic blood pressure was significantly associated both with nonlobar and lobar PICH. Diabetes and psychiatric morbidity were associated with nonlobar PICH. Smoking doubled the risk for lobar PICH, but was unrelated to nonlobar PICH.


CONCLUSIONS
In this prospective population-based study, hypertension, diabetes, height, triglycerides and psychiatric morbidity were risk factors for PICH. Smoking was a risk factor for lobar PICH only.
Zia
Elisabet
E
Department of Neurology, Malmo University Hospital, Malmo, Sweden. elisabet.zia@skane.se
Pessah-Rasmussen
Hélène
H
Khan
Farhad Ali
FA
Norrving
Bo
B
Janzon
Lars
L
Berglund
Goran
G
Engstrom
Gunnar
G
D000328:Adult; D001827:Body Height; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008019:Life Style; D008297:Male; D017533:Marital Status; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology