Importance: Subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms is a subset of stroke with high fatality and morbidity. Better understanding of a change in incidence over time and of factors associated with this change could facilitate primary prevention.
Objective: To assess worldwide SAH incidence according to region, age, sex, time period, blood pressure, and smoking prevalence.
Data Sources: We searched PubMed, Web of Science, and Embase for studies on SAH incidence published between January 1960 and March 2017. Worldwide blood pressure and smoking prevalence data were extracted from the Noncommunicable Disease Risk Factor and Global Burden of Disease data sets.
Study Selection: Population-based studies with prospective designs representative of the entire study population according to predefined criteria.
Data Extraction And Synthesis: Two reviewers independently extracted data according to PRISMA guidelines. Incidence of SAH was calculated per 100 000 person-years, and risk ratios (RRs) including 95% CIs were calculated with multivariable random-effects binomial regression. The association of SAH incidence with blood pressure and smoking prevalence was assessed with linear regression.
Main Outcomes And Measures: Incidence of SAH.
Results: A total of 75 studies from 32 countries were included. These studies comprised 8176 patients with SAH were studied over 67 746 051 person-years. Overall crude SAH incidence across all midyears was 7.9 (95% CI, 6.9-9.0) per 100 000 person-years; the RR for women was 1.3 (95% CI, 0.98-1.7). Compared with men aged 45 to 54 years, the RR in Japanese women older than 75 years was 2.5 (95% CI, 1.8-3.4) and in European women older than 75 years was 1.5 (95% CI, 0.9-2.5). Global SAH incidence declined from 10.2 (95% CI, 8.4-12.5) per 100 000 person-years in 1980 to 6.1 (95% CI, 4.9-7.5) in 2010 or by 1.7% (95% CI, 0.6-2.8) annually between 1955 and 2014. Incidence of SAH declined between 1980 and 2010 by 40.6% in Europe, 46.2% in Asia, and 14.0% in North America and increased by 59.1% in Japan. The global SAH incidence declined with every millimeter of mercury decrease in systolic blood pressure by 7.1% (95% CI, 5.8-8.4) and with every percentage decrease in smoking prevalence by 2.4% (95% CI, 1.6-3.3).
Conclusions And Relevance: Worldwide SAH incidence and its decline show large regional differences and parallel the decrease in blood pressure and smoking prevalence. Understanding determinants for regional differences and further reducing blood pressure and smoking prevalence may yield a diminished SAH burden.
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http://dx.doi.org/10.1001/jamaneurol.2019.0006 | DOI Listing |
EClinicalMedicine
October 2024
Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada.
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Department of Gastroenterology, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece.
Machine learning (ML) is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis, thus creating machines that can complete tasks otherwise requiring human intelligence. Among its various applications, it has proven groundbreaking in healthcare as well, both in clinical practice and research. In this editorial, we succinctly introduce ML applications and present a study, featured in the latest issue of the .
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Division of Hypertension, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Front Pharmacol
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Department of Obstetrics and Gynecology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
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View Article and Find Full Text PDFHigh blood pressure is a significant risk factor for cardiovascular diseases and is linked to an increased risk of mild cognitive impairment (MCI). The lack of effective treatments for these conditions highlights the urgent need for novel therapeutic approaches. Recent research suggests that the gut microbiota-brain-gut axis plays a crucial role in the pathogenesis of hypertension and MCI by regulating the nervous, endocrine, and immune systems.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!