Risk Factors of Intracerebral Hemorrhage: A Case-Control Study

J Stroke Cerebrovasc Dis. 2020 Apr;29(4):104630. doi: 10.1016/j.jstrokecerebrovasdis.2019.104630. Epub 2020 Jan 17.

Abstract

Background: Hypertension is a well-known risk factor for intracerebral hemorrhage (ICH). On many of the other potential risk factors, such as smoking, diabetes, and alcohol intake, results are conflicting. We assessed risk factors of ICH, taking also into account prior depression and fatigue.

Methods: This is a population-based case-control study of 250 primary ICH patients, conducted in Helsinki University Hospital, Finland. The controls (n = 750) were participants of the FINRISK study, a large Finnish population survey on risk factors of chronic noncommunicable diseases, matched with cases by sex and age. Ages were matched in 5-year age bands. However, as the oldest FINRISK participants were 74-year-olds, controls for the age group 75-84 were selected from the age group of 70-74 years. Patients aged greater than or equal to 85 years were excluded. Patients and controls were compared in univariate analyses. The age categories less than 70, and greater than or equal to 70 years were also analyzed separately. Binary logistic regression analysis was performed for variables with P less than .1 in univariate analysis.

Results: Analyzing all cases and controls, the cases had more hypertension, history of heart attack, lipid-lowering medication, and reported more frequently fatigue prior to ICH. In persons aged less than 70 years, hypertension and fatigue were more common among cases. In persons aged greater than or equal to 70 years, factors associated with risk of ICH were fatigue prior to ICH, use of lipid-lowering medication, and overweight.

Conclusions: Hypertension was associated with risk of ICH among all patients and in the group of patients under 70 years. Fatigue prior to ICH was more common among all ICH cases.

Keywords: Intracerebral hemorrhage; case-control study; hypertension; risk factor.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Case-Control Studies
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / etiology*
  • Cerebral Hemorrhage / physiopathology
  • Depression / complications
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy
  • Fatigue / complications
  • Female
  • Finland
  • Health Status
  • Humans
  • Hypertension / complications
  • Hypertension / physiopathology
  • Hypolipidemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Risk Assessment
  • Risk Factors

Substances

  • Hypolipidemic Agents