title: Risk factors and their combined effects on the incidence rate of subarachnoid hemorrhage--a population-based cohort study.
abstract: BACKGROUND
  Prospective studies on the risk factors for subarachnoid hemorrhage (SAH) are limited. Moreover, the effect of risk factors on the incidence rates of SAH is not well known about.
  
  
  OBJECTIVE
  In this study, we aimed to identify risk factors for SAH and characterize subgroups in a population with a high incidence of SAH.
  
  
  METHODS
  After recording multiple potential risk factors for SAH at the time of enrollment, first ever SAH events between 1972 and 2009 were recorded through the nationwide Causes of Death Register and Hospital Discharge Register for the population-based cohort of 64 349 participants, who participated in the National FINRISK Study between 1972 and 2007 in Finland.
  
  
  RESULTS
  During the follow-up time of 1.26 million person-years (median 17.9 years, range 0 to 37.9 years), 437 persons experienced fatal or non-fatal SAH. Crude SAH incidence was 34.8 (95% confidence interval: 31.7-38.2) per 100 000 person-years among ≥ 25-year-old persons. Female sex, high blood pressure values and current smoking were confirmed as risk factors for SAH. Previous myocardial infarction, history of premature stroke (any kind) in mother and elevated cholesterol levels in men were identified as new risk factors for SAH. Depending on the combination of risk factors, SAH incidence varied between 8 and 171 per 100 000 person-years.
  
  
  CONCLUSIONS
  New and previously reported risk factors appear to have a much stronger association with the incidence of SAH than is ordinarily seen in cardiovascular diseases. Risk factor assessments may facilitate the identification of high-risk persons who should be the focus of preventive interventions.
authors.affiliation: Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland ; Neurosurgery Unit, Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Miikka
authors.initials: M
authors.lastname: Korja
authors.forename: Karri
authors.initials: K
authors.lastname: Silventoinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.forename: Pekka
authors.initials: P
authors.lastname: Jousilahti
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Juha
authors.initials: J
authors.lastname: Hernesniemi
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D005192:Family Health; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods*; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000401:mortality
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