Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
J Neurol Neurosurg Psychiatry. 2020 Sep;91(9):985-990. doi: 10.1136/jnnp-2020-323753. Epub 2020 Jul 28.
We previously reported a single-centre study demonstrating that smoking confers a six-fold increased risk for having an unruptured intracranial aneurysm (UIA) in women aged between 30 and 60 years and this risk was higher if the patient had chronic hypertension. There are no data with greater generalisability evaluating this association. We aimed to validate our previous findings in women from a multicentre study.
A multicentre case-control study on women aged between 30 and 60 years, that had magnetic resonance angiography (MRA) during the period 2016-2018. Cases were those with an incidental UIA, and these were matched to controls based on age and ethnicity. A multivariable conditional logistic regression was conducted to evaluate smoking status and hypertension differences between cases and controls.
From 545 eligible patients, 113 aneurysm patients were matched to 113 controls. The most common reason for imaging was due to chronic headaches in 62.5% of cases and 44.3% of controls. A positive smoking history was encountered in 57.5% of cases and in 37.2% of controls. A multivariable analysis demonstrated a significant association between positive smoking history (OR 3.7, 95%CI 1.61 to 8.50), hypertension (OR 3.16, 95% CI 1.17 to 8.52) and both factors combined with a diagnosis of an incidental UIA (OR 6.9, 95% CI 2.49 to 19.24).
Women aged between 30 and 60 years with a positive smoking history have a four-fold increased risk for having an UIA, and a seven-fold increased risk if they have underlying chronic hypertension. These findings indicate that women aged between 30 and 60 years with a positive smoking history might benefit from a screening recommendation.
我们之前的一项单中心研究表明，吸烟使 30 至 60 岁女性发生未破裂颅内动脉瘤（UIA）的风险增加 6 倍，如果患者患有慢性高血压，则风险更高。目前尚无更具普遍性的数据来评估这种关联。我们旨在通过一项多中心研究来验证我们之前的发现。
这是一项针对 30 至 60 岁女性的多中心病例对照研究，这些女性在 2016 年至 2018 年期间进行了磁共振血管造影（MRA）检查。病例为偶然发现的 UIA 患者，这些患者根据年龄和种族与对照组相匹配。采用多变量条件逻辑回归分析评估病例组和对照组之间的吸烟状况和高血压差异。
在 545 名符合条件的患者中，有 113 名动脉瘤患者与 113 名对照者相匹配。62.5%的病例和 44.3%的对照者因慢性头痛进行影像学检查。57.5%的病例和 37.2%的对照者有吸烟史。多变量分析显示，阳性吸烟史（OR 3.7，95%CI 1.61 至 8.50）、高血压（OR 3.16，95%CI 1.17 至 8.52）以及两者同时存在与偶然诊断为 UIA 显著相关（OR 6.9，95%CI 2.49 至 19.24）。
30 至 60 岁有阳性吸烟史的女性发生 UIA 的风险增加 4 倍，如果同时患有慢性高血压，则风险增加 7 倍。这些发现表明，30 至 60 岁有阳性吸烟史的女性可能受益于筛查建议。
