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Intracerebral Hemorrhage Incidence Rate Stabilizing

Continued increase in incidence for those ≥75 years coincides with increase in use of anticoagulant meds

MONDAY, June 8, 2020 (HealthDay News) — In the past 30 years, rates of intracerebral hemorrhage (ICH) incidence have stabilized, according to a study published online June 8 in JAMA Neurology.

Vasileios-Arsenios Lioutas, M.D., from the Beth Israel Deaconess Medical Center in Boston, and colleagues assessed the long-term population-based trends in the incidence of ICH. The analysis included 5,209 original participants and 5,124 offspring participants from the Framingham Heart Study who were followed from 1948 through 2016 (period 1, 1948 to 1986; period 2, 1987 to 1999; and period 3, 2000 to 2016).

The researchers found that 129 patients (55.8 percent women; mean age, 77 years) experienced a primary ICH incident during follow-up, with an incidence rate of 43 cases per 100,000 person-years. Over time, the unadjusted incidence rate increased, but in the last 30 years, the age-adjusted incidence rate decreased slightly. Among patients ≥75 years, an age-stratified analysis indicated a continued increase in ICH incidence. In period 3, there was a concurrent threefold increase in the use of anticoagulant medications (4.4 percent in period 2 to 13.9 percent in period 3). For both lobar and deep ICH, the incidence rate increased substantially with age. The incidence of deep ICH was associated with higher systolic and diastolic blood pressure and statin medication use (odds ratio, 4.07). The incidence of lobar ICH was associated with higher systolic blood pressure and apolipoprotein E ε4 allele homozygosity (odds ratio, 3.66).

“Given the lack of therapy to treat ICH, emphasis should be placed on prevention, which needs to be optimized and intensified,” the authors write.

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