Gender and ethnic differences in subarachnoid hemorrhage

Abstract

Background and Purpose Mexican Americans (MAs) comprise the largest component of the largest minority group within the United States. The purpose of this study was to examine ethnic and gender differences in the epidemiology, presentation and outcomes after subarachnoid hemorrhage (SAH) in a representative United States community. Targeted public health interventions are dependent on accurate assessments of groups at highest disease risk. Methods All non-traumatic SAH patients older than 44 years were prospectively identified from January 1, 2000 to December 31, 2006 as part of the Brain Attack Surveillance In Corpus Christi (BASIC) project, an urban population-based study in southeast Texas. Risk ratios for cumulative SAH incidence comparing MAs with non Hispanic whites (NHWs), and women with men were calculated. Descriptive statistics for other clinical and demographic variables were computed overall, by gender and by ethnicity. Results A total of 107 patients had a SAH during the time period (seven-year cumulative incidence: 11/10,000); of these, 43 were NHW (40% of cases vs. 53% of the population) and 64 were MA (60% of cases vs. 48% of the population). The overall age-adjusted risk ratio for SAH in MAs compared with NHWs was 1.67 (95% CI: 1.13, 2.47), and in women compared to men was 1.74 (95% CI 1.16, 2.62). Overall in-hospital mortality was 32.2%. No ethnic difference was observed for discharge disability or in-hospital mortality. Conclusions SAH disproportionately affects MAs and women. Public health interventions should target these groups to reduce the impact of this severe disease.

Trends in the mortality of non-traumatic subarachnoid hemorrhage in Colombia: a 10-year analysis of a nationwide registry

“…This finding is consistent with several population-based studies that estimate an increased incidence and mortality in women, but predominantly after the menopause 4,18 . Most previous studies show a higher incidence of SAH after 50 years of age 4,[18][19][20] ; however, in the present study the disparity in mortality rates was detected at a younger age and increased with age. In Colombian women, the mean age of menopause is between 47 and 53 years old 21 ; therefore, this finding suggests that factors involved in the pathogenesis of IA and in inducing SAH begin just before the menopause rather than after, as was previously believed 4,18 .…”

Guidelines for the Prevention of Stroke in Women

“…44,45 Data reported from non-US populations have shown differing sex-related patterns across countries, with higher SAH incidence among men in Finland and eastern Europe, possibly because of regional differences in risk factor prevalence in men and women. 46 The incidence Table 1.…”

Variation in the Caudal Branches of the External Carotid Artery: Comparison of Sex and Side

“…While variability regarding arterial characteristics (e.g., wall thickness, vessel diameter) between populations (sex, ethnicity) has been directly examined in some arterial systems (Eden et al 2008, Lindekleiv et al 2010, Müller et al 1991, Schulz and Rothwell 2001, very little has been reported contrasting the differences in ECA branching pattern between sex and side. This study assessed the origin of the caudal four ECA branches to compare the anatomy of males versus females, and right versus left neck.…”