Attributable risk of common and rare determinants of subarachnoid hemorrhage

• Published in: Stroke (1970) Vol. 32; no. 5; pp. 1173 - 1175
• Main Authors: RUIGROK, Ynte M, BUSKENS, Erik, RINKEL, Gabriël J. E
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-05-2001; American Heart Association, Inc
• Subjects: Alcohol-Induced Disorders, Nervous System - epidemiology; Biological and medical sciences; Causality; Comorbidity; Genetic Predisposition to Disease; Humans; Hypertension - epidemiology; Incidence; Medical sciences; Neurology; Polycystic Kidney, Autosomal Dominant - epidemiology; Polycystic Kidney, Autosomal Dominant - genetics; Prevalence; Risk; Risk Assessment; Risk Factors; Smoking - epidemiology; Subarachnoid Hemorrhage - epidemiology; Subarachnoid Hemorrhage - genetics; Vascular diseases and vascular malformations of the nervous system; Netherlands; Europe; Vascular disease; Human; Nervous system diseases; Central nervous system disease; Risk factor; Subarachnoid; Cardiovascular disease; Epidemiology; Hemorrhage; Cerebrovascular disease; Cerebral disorder
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.str.32.5.1173

Smoking, hypertension, alcohol consumption, autosomal dominant polycystic kidney disease (ADPKD), and positive family history for subarachnoid hemorrhage (SAH) are well-known risk factors for SAH. For effective prevention, knowledge about the contribution of these risk factors to the overall occurrence of SAH in the general population is pivotal. We therefore investigated the population attributable risks of the risk factors for SAH.
We retrieved the relative risk and prevalence of established risk factors for SAH from the literature and calculated the population attributable risks of these risk factors.
Drinking alcohol 100 to 299 g/wk accounted for 11% of the cases of SAH, drinking alcohol >/=300 g/wk accounted for 21%, and smoking accounted for 20%. An additional 17% of the cases could be attributed to hypertension, 11% to a positive family history for SAH, and 0.3% to ADPKD.
Screening and preventive treatment of patients with familial preponderance of SAH alone will cause a modest reduction of the incidence of SAH in the general population. Further reduction can be achieved by reducing the prevalence of the modifiable risk factors alcohol consumption, smoking, and hypertension.