Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India.
Cerebrovasc Dis. 2010 Feb;29(3):268-74. doi: 10.1159/000275501. Epub 2010 Jan 15.
Aneurysmal subarachnoid hemorrhage (aSAH) has a mortality rate as high as 50%. The prevalence of intracranial aneurysms from various parts of India varies from 0.75 to 10.3%, with higher numbers of cases being diagnosed due to the increasing age of the population and improvements in imaging techniques. However, little is known about the attributable risk factors of aSAH in the Indian population.
Using a case-control study we estimated the risk of factors such as hypertension, cigarette smoking, alcohol consumption, diabetes mellitus and family history of aSAH in a South Indian population. The population-attributable risk (PAR) of smoking, hypertension and alcohol use was estimated for the South Indian as well as for the general Indian population.
Our results showed that cigarette smoking (OR, 3.59; p < 0.001) and a history of hypertension (OR, 2.98; p < 0.001) were significant risk factors associated with aSAH. When patients were classified by gender, it was observed that being a smoker and having hypertension increased the risk for aSAH by nearly fourfold in men. Among women, hypertension and older age were significant risk factors. The PAR estimates indicated that smoking (OR, 3.59; 95% CI, 2.13-6.06) and hypertension (OR, 2.98; 95% CI, 1.73-5.12) are significant risk factors.
Hypertension and smoking may be causal risk factors which might also modify the effect of genetic factors that could increase susceptibility to aSAH in the Indian population. Since these risk factors are amenable to effective modification, our findings will be useful for a gender-specific management of aSAH.
颅内动脉瘤性蛛网膜下腔出血(aSAH)的死亡率高达 50%。印度不同地区颅内动脉瘤的患病率在 0.75%至 10.3%之间，由于人口老龄化和成像技术的提高，诊断出的病例数量有所增加。然而，对于印度人群中 aSAH 的归因危险因素知之甚少。
使用病例对照研究，我们估计了南印度人群中高血压、吸烟、饮酒、糖尿病和 aSAH 家族史等因素的风险。我们还估计了吸烟、高血压和饮酒对南印度和整个印度人群的人群归因风险(PAR)。
我们的结果表明，吸烟(OR，3.59；p < 0.001)和高血压病史(OR，2.98；p < 0.001)是与 aSAH 相关的显著危险因素。当按性别对患者进行分类时，观察到吸烟和高血压使男性患 aSAH 的风险增加近四倍。在女性中，高血压和年龄较大是显著的危险因素。PAR 估计表明，吸烟(OR，3.59；95%CI，2.13-6.06)和高血压(OR，2.98；95%CI，1.73-5.12)是显著的危险因素。
高血压和吸烟可能是因果危险因素，也可能改变遗传因素的作用，从而增加印度人群患 aSAH 的易感性。由于这些危险因素可以有效改变，我们的发现将有助于对 aSAH 进行性别特异性管理。
