Abstract
Background: Aneurysmal subarachnoid haemorrhage (aSAH) disproportionally affects women. We conducted a systematic review and meta-analysis to explore sex differences in aSAH risk factors. 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. Registration PROSPERO (ID: CRD42018091521).
| Original language | English |
|---|---|
| Article number | 116446 |
| Number of pages | 9 |
| Journal | Journal of the Neurological Sciences |
| Volume | 406 |
| DOIs | |
| Publication status | Published - 15 Nov 2019 |
Keywords
- Risk factors
- Sex characteristics
- Subarachnoid haemorrhage
Cite this
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Sex differences in risk factors for aneurysmal subarachnoid haemorrhage : Systematic review and meta-analysis. / Rehman, Sabah; Sahle, Berhe W.; Chandra, Ronil V.; Dwyer, Mitchell; Thrift, Amanda G.; Callisaya, Michele; Breslin, Monique; Phan, Hoang T.; Otahal, Petr; Gall, Seana.
In: Journal of the Neurological Sciences, Vol. 406, 116446, 15.11.2019.Research output: Contribution to journal › Review Article › Research › peer-review
TY - JOUR
T1 - Sex differences in risk factors for aneurysmal subarachnoid haemorrhage
T2 - Systematic review and meta-analysis
AU - Rehman, Sabah
AU - Sahle, Berhe W.
AU - Chandra, Ronil V.
AU - Dwyer, Mitchell
AU - Thrift, Amanda G.
AU - Callisaya, Michele
AU - Breslin, Monique
AU - Phan, Hoang T.
AU - Otahal, Petr
AU - Gall, Seana
PY - 2019/11/15
Y1 - 2019/11/15
N2 - Background: Aneurysmal subarachnoid haemorrhage (aSAH) disproportionally affects women. We conducted a systematic review and meta-analysis to explore sex differences in aSAH risk factors. 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. Registration PROSPERO (ID: CRD42018091521).
AB - Background: Aneurysmal subarachnoid haemorrhage (aSAH) disproportionally affects women. We conducted a systematic review and meta-analysis to explore sex differences in aSAH risk factors. 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. Registration PROSPERO (ID: CRD42018091521).
KW - Risk factors
KW - Sex characteristics
KW - Subarachnoid haemorrhage
UR - http://www.scopus.com/inward/record.url?scp=85072053751&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2019.116446
DO - 10.1016/j.jns.2019.116446
M3 - Review Article
VL - 406
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
M1 - 116446
ER -