title: Hypertension predisposes to the formation of saccular intracranial aneurysms in 467 unruptured and 1053 ruptured patients in Eastern Finland.
abstract: OBJECTIVE
  Hypertension associates with subarachnoid hemorrhage from saccular intracranial aneurysm (sIA-SAH) when compared to matched controls or general population. Few series compare hypertension in unruptured sIA versus sIA-SAH, so its impact on the sIA disease remains uncertain.
  
  
  METHODS
  Kuopio sIA Database ( www.uef.fi/ns ) contains all cases of unruptured and ruptured sIAs admitted to Kuopio University Hospital from its Eastern Finnish catchment population. We compared the age-adjusted incidence of drug-treated hypertension in 467 unruptured and 1053 ruptured sIA patients admitted to Kuopio University Hospital from 1995 to 2007, using the national registry of prescribed medicines.
  
  
  RESULTS
  Antihypertensive medication was more frequent in the unruptured (73% versus 62%) with higher age-adjusted incidence. At sIA diagnosis, the sIA-SAH group had more often untreated hypertension (29% versus 23%). The size of unruptured sIAs increased with age at sIA diagnosis, independently of hypertension. Multiple sIAs, familial sIA, and sIA-SAH were not associated with hypertension in multivariate analysis. Results indicate that drug-treated hypertension associates with the formation of sIAs rather than their growth or rupture.
  
  
  CONCLUSIONS
  Hypertension is highly prevalent in the carriers of unruptured sIAs when compared to those with ruptured sIA. Hypertension may associate with the sIA formation, and may predispose to the rupture of sIA if untreated.
authors.affiliation: Neurosurgery of NeuroCenter, Kuopio University Hospital , Kuopio , Finland.
authors.forename: Antti E
authors.initials: AE
authors.lastname: Lindgren
authors.forename: Mitja I
authors.initials: MI
authors.lastname: Kurki
authors.forename: Annamaija
authors.initials: A
authors.lastname: Riihinen
authors.forename: Timo
authors.initials: T
authors.lastname: Koivisto
authors.forename: Antti
authors.initials: A
authors.lastname: Ronkainen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Rinne
authors.forename: Juha
authors.initials: J
authors.lastname: Hernesniemi
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.forename: Juha E
authors.initials: JE
authors.lastname: Jääskeläinen
authors.forename: Mikael
authors.initials: M
authors.lastname: von und zu Fraunberg
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015994:Incidence; D002532:Intracranial Aneurysm / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D012907:Smoking / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000209:etiology*
chemical_list: D000959:Antihypertensive Agents