BACKGROUND AND PURPOSE: The joint effect of risk factors on the risk of aneurysmal SAH (aSAH) has been studied sparsely. METHODS: We examined the potential synergism between cigarette smoking, hypertension, and regular alcohol consumption and the risk of aSAH in a prospective, population-based cohort of participants from the Nord-Trøndelag Health Study and the Tromsø Study in Norway. Interaction was assessed on additive and multiplicative scales. RESULTS: We identified 122 cases of aSAH over 977 895 person-years of follow-up. Interaction was observed between current smoking and hypertension on the additive scale, (relative excess risk because of interaction, 6.40; 95% CI, 0.88-11.92, adjusted for sex and age). We found no significant interaction between hypertension and regular alcohol consumption or current cigarette smoking and regular alcohol consumption on the additive scale. No significant interaction was detected on the multiplicative scale. CONCLUSIONS: The joint effect of current smoking and hypertension on the risk of aSAH was stronger than was the sum of the independent effects of each factor. Persons at risk of aSAH should be advised of a markedly stronger risk for aSAH with the combination of current smoking and hypertension. In addition, the finding suggests that combining smoking cessation and blood pressure lowering may have an extra risk reduction effect on preventing aSAH.
BACKGROUND AND PURPOSE: The joint effect of risk factors on the risk of aneurysmal SAH (aSAH) has been studied sparsely. METHODS: We examined the potential synergism between cigarette smoking, hypertension, and regular alcohol consumption and the risk of aSAH in a prospective, population-based cohort of participants from the Nord-Trøndelag Health Study and the Tromsø Study in Norway. Interaction was assessed on additive and multiplicative scales. RESULTS: We identified 122 cases of aSAH over 977 895 person-years of follow-up. Interaction was observed between current smoking and hypertension on the additive scale, (relative excess risk because of interaction, 6.40; 95% CI, 0.88-11.92, adjusted for sex and age). We found no significant interaction between hypertension and regular alcohol consumption or current cigarette smoking and regular alcohol consumption on the additive scale. No significant interaction was detected on the multiplicative scale. CONCLUSIONS: The joint effect of current smoking and hypertension on the risk of aSAH was stronger than was the sum of the independent effects of each factor. Persons at risk of aSAH should be advised of a markedly stronger risk for aSAH with the combination of current smoking and hypertension. In addition, the finding suggests that combining smoking cessation and blood pressure lowering may have an extra risk reduction effect on preventing aSAH.
Authors: Anil Can; Victor M Castro; Yildirim H Ozdemir; Sarajune Dagen; Dmitriy Dligach; Sean Finan; Sheng Yu; Vivian Gainer; Nancy A Shadick; Guergana Savova; Shawn Murphy; Tianxi Cai; Scott T Weiss; Rose Du Journal: Transl Stroke Res Date: 2017-07-27 Impact factor: 6.829
Authors: Philippe Bijlenga; Akio Morita; Nerissa U Ko; J Mocco; Sandrine Morel; Yuichi Murayama; Marieke J H Wermer; Robert D Brown Journal: Neurocrit Care Date: 2019-06 Impact factor: 3.210
Authors: Anil Can; Victor M Castro; Yildirim H Ozdemir; Sarajune Dagen; Sheng Yu; Dmitriy Dligach; Sean Finan; Vivian Gainer; Nancy A Shadick; Shawn Murphy; Tianxi Cai; Guergana Savova; Ruben Dammers; Scott T Weiss; Rose Du Journal: Neurology Date: 2017-08-30 Impact factor: 9.910
Authors: Benjamin W Y Lo; Hitoshi Fukuda; Mark Angle; Jeanne Teitelbaum; R Loch Macdonald; Forough Farrokhyar; Lehana Thabane; Mitchell A H Levine Journal: Surg Neurol Int Date: 2016-08-01
Authors: Miikka Korja; Karri Silventoinen; Tiina Laatikainen; Pekka Jousilahti; Veikko Salomaa; Juha Hernesniemi; Jaakko Kaprio Journal: PLoS One Date: 2013-09-09 Impact factor: 3.240