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Risk factors for subarachnoid hemorrhage: a systematic review Teunissen LL; Rinkel GJ; Algra A; van Gijn JStroke 1996[Mar]; 27 (3): 544-9BACKGROUND AND PURPOSE: Knowledge of modifiable risk factors for subarachnoid hemorrhage (SAH) is important in terms of prevention. We therefore conducted a systematic review of studies on risk factors for SAH, with emphasis on sufficiently precise criteria for the diagnosis of SAH. METHODS: To identify studies we performed a Medline search from 1966 to 1994 and searched the reference lists of all relevant publications. Studies were included only if they fulfilled predefined methodological criteria. Case-control studies were included if the diagnosis of SAH was proved by CT, angiography, or autopsy in at least 70% of patients. Longitudinal studies were included if the criteria for SAH were based on a review of the medical records. RESULTS: Nine longitudinal studies and 11 case-control studies were included. Significant risk factors were as follows: (1) smoking (relative risk [RR] for longitudinal studies, 1.9; 95% confidence interval [CI], 1.5 to 2.3; odds ratio [OR] for case-control studies, 3.5; 95% CI, 2.9 to 4.3); (2) hypertension (RR, 2.8; 95% CI, 2.1 to 3.6; OR, 2.9; 95% CI, 2.4 to 3.7) and (3) drinking 150 g or more of alcohol per week (RR, 4.7; 95% CI, 2.1 to 10.5; OR, 1.5; 95% CI, 1.1 to 1.9). Use of oral contraceptives, hormone replacement therapy, hypercholesterolemia, and physical activity were not significantly related to the risk of SAH. CONCLUSIONS: We conclude that smoking, hypertension, and alcohol abuse are important risk factors for SAH. Reduction of exposure to these risk factors might result in a decreased incidence of SAH.|Alcohol Drinking/adverse effects[MESH]|Autopsy[MESH]|Case-Control Studies[MESH]|Cerebral Angiography[MESH]|Confidence Intervals[MESH]|Contraceptives, Oral/therapeutic use[MESH]|Estrogen Replacement Therapy[MESH]|Female[MESH]|Humans[MESH]|Hypercholesterolemia/complications[MESH]|Hypertension/complications[MESH]|Longitudinal Studies[MESH]|Male[MESH]|Motor Activity[MESH]|Odds Ratio[MESH]|Retrospective Studies[MESH]|Risk Assessment[MESH]|Risk Factors[MESH]|Smoking/adverse effects[MESH]|Subarachnoid Hemorrhage/diagnosis/*etiology/prevention & control[MESH]|Tomography, X-Ray Computed[MESH] |