title: Burden of blood pressure-related alleles is associated with larger hematoma volume and worse outcome in intracerebral hemorrhage.
abstract: OBJECTIVE
  Intracerebral hemorrhage (ICH) is the acute manifestation of a progressive disease of the cerebral small vessels. The severity of this disease seems to influence not only risk of ICH but also the size of the hematoma. As the burden of high blood pressure-related alleles is associated with both hypertension-related end-organ damage and risk of ICH, we sought to determine whether this burden influences ICH baseline hematoma volume.
  
  
  METHODS
  Prospective study in subjects of European descent with supratentorial ICH who underwent genome-wide genotyping. Forty-two single nucleotide polymorphisms associated with high blood pressure were identified from a publicly available database. A genetic risk score was constructed based on these single nucleotide polymorphisms. The score was used as the independent variable in univariate and multivariate regression models for admission ICH volume and poor clinical outcome (modified Rankin Scale, 3-6).
  
  
  RESULTS
  A total of 323 ICH cases were enrolled in the study (135 deep and 188 lobar intracranial hematomas). The blood pressure-based genetic risk score was associated with both baseline hematoma volume and poor clinical outcome specifically in deep ICH. In multivariate regression analyses, each additional SD of the score increased mean deep ICH volume by 28% (or 2.7 mL increase; β=0.28; SE=0.11; P=0.009) and risk of poor clinical outcome by 71% (odds ratio, 1.71; 95% confidence interval, 1.05-2.80; P=0.03).
  
  
  CONCLUSIONS
  Increasing numbers of high blood pressure-related alleles are associated with mean baseline hematoma volume and poor clinical outcome in ICH. These findings suggest that the small vessel vasculopathy responsible for the occurrence of the hemorrhage also influences its volume.
authors: Center for Human Genetic Research, Massachusetts General Hospital, 185 Cambridge St, CPZN-6818, Boston, MA 02114, USA.
authors: Guido J
authors: GJ
authors: Falcone
authors: Alessandro
authors: A
authors: Biffi
authors: William J
authors: WJ
authors: Devan
authors: H Bart
authors: HB
authors: Brouwers
authors: Christopher D
authors: CD
authors: Anderson
authors: Valerie
authors: V
authors: Valant
authors: Alison M
authors: AM
authors: Ayres
authors: Kristin
authors: K
authors: Schwab
authors: Natalia S
authors: NS
authors: Rost
authors: Joshua N
authors: JN
authors: Goldstein
authors: Anand
authors: A
authors: Viswanathan
authors: Steven M
authors: SM
authors: Greenberg
authors: Magdy
authors: M
authors: Selim
authors: James F
authors: JF
authors: Meschia
authors: Devin L
authors: DL
authors: Brown
authors: Bradford B
authors: BB
authors: Worrall
authors: Scott L
authors: SL
authors: Silliman
authors: David L
authors: DL
authors: Tirschwell
authors: Jonathan
authors: J
authors: Rosand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D001794:Blood Pressure / Q000235:genetics*; D002543:Cerebral Hemorrhage / Q000235:genetics* / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D055106:Genome-Wide Association Study / Q000379:methods; D005838:Genotype; D006407:Hematoma, Epidural, Cranial / Q000235:genetics* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011446:Prospective Studies; D016896:Treatment Outcome