Rehman, S and Sahle, BW and Chandra, RV and Dwyer, M and Thrift, AG and Callisaya, M and Breslin, M and Phan, HT and Otahal, P and Gall, S, Sex differences in risk factors for aneurysmal subarachnoid haemorrhage: systematic review and meta-analysis, Journal of the Neurological Sciences, 406 Article 116446. ISSN 0022-510X (2019) [Refereed Article]
Copyright 2019 Elsevier B.V.
Methods: Case-control/cohort studies were searched to November 2017 with sex-specific risk factors for aSAH. Meta-analysis was performed when a risk factor was reported in ≥2 studies.
Results: Of 31 studies, 22 were eligible for meta-analysis. Female sex was associated with greater odds of aSAH (HRadjusted 1.90 [1.47-2.46]. There was no detectable difference between the sexes for hypertension (ORadjusted: men 3.13 [2.26-4.34]; women 3.65 [2.87-4.63], p = .18), smoking (ORadjusted: men 2.96 [1.68-5.21]; women 3.11 [1.21-7.97], p = .95), aSAH family history, systolic blood pressure, age and some genetic variations. Alcohol (ORadjusted: men 1.50 [1.04-2.17]; women 0.83 [0.48-1.45], p = .003), high alanine aminotransferase levels, and some gene variants increased the risk of aSAH in men. Reproductive factors, divorce and some genetic variations increased the risk in women. High aspartate aminotransferase levels in men and, diabetes (ORadjusted: men 0.57 [0.32-1.01]; women 0.24 [0.13-0.43], p = .01) and parity in women reduced aSAH risk.
Conclusion: We recommend sex-specific re-analysis of existing studies of aSAH risk factors. Known aSAH risk factors (hypertension, smoking and alcohol consumption) should be targeted to prevent aSAH in men and women.
|Item Type:||Refereed Article|
|Keywords:||risk factors, sex characteristics, subarachnoid haemorrhage|
|Research Division:||Medical and Health Sciences|
|Research Field:||Neurology and Neuromuscular Diseases|
|Objective Group:||Health and Support Services|
|Objective Field:||Evaluation of Health Outcomes|
|UTAS Author:||Rehman, S (Dr Sabah Rehman)|
|UTAS Author:||Sahle, BW (Mr Berhe Sahle)|
|UTAS Author:||Dwyer, M (Mr Mitchell Dwyer)|
|UTAS Author:||Callisaya, M (Dr Michele Callisaya)|
|UTAS Author:||Breslin, M (Dr Monique Breslin)|
|UTAS Author:||Phan, HT (Miss Hoang Phan)|
|UTAS Author:||Otahal, P (Mr Petr Otahal)|
|UTAS Author:||Gall, S (Associate Professor Seana Gall)|
|Deposited By:||Menzies Institute for Medical Research|
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