Regular medication as a risk factor for intracranial aneurysms: A comparative case–control study

Abstract

Background: Previous medical history strongly contributes to the genesis of intracranial aneurysms (IA). A possible impact of regular medication on the occurrence of abdominal aortic aneurysms has been reported. Aim: To evaluate the value of regular medication on the risk of development and rupture of IA. Methods: Data on medication use and related comorbidities were obtained from the institutional IA registry. A 1:1 age- and sex-matched patient sample was collected from the population-based Heinz Nixdorf Recall Study with individuals from the same area. Results: In the analysis comparing IA cohort ( n = 1960) with the matched normal population ( n = 1960), the use of statins (adjusted odds ratio, 1.34 [95% confidence interval 1.02–1.78]), antidiabetics (1.46 [1.08–1.99]), and calcium channel blockers (1.49 [1.11–2.00]) was independently associated with higher risk of IA, whereas uricostatics (0.23 [0.14–0.38]), aspirin (0.23 [0.13–0.43]), beta-blockers (0.51 [0.40–0.66]), and angiotensin-converting enzyme inhibitors (0.38 [0.27–0.53]) were related to lower risk of IA. In the multivariable analysis within the IA cohort ( n = 2446), SAH patients showed higher drug exposure with thiazide diuretics (2.11 [1.59–2.80]), but lower prevalence of remaining antihypertensive medication—beta-blockers (0.38 [0.30–0.48]), calcium channel blockers (0.63 [0.48–0.83]), angiotensin-converting enzyme inhibitors (0.56 [0.44–0.72]), and angiotensin-1 receptor blockers (0.33 [0.24–0.45]). Patients with ruptured IA were less likely to be treated with statins (0.62 [0.47–0.81]), thyroid hormones (0.62 [0.48–0.79]), and aspirin (0.55 [0.41–0.75]). Conclusions: Regular medication might impact the risks related to the development and rupture of IA. Further clinical trials are required to clarify the effect of regular medication on IA genesis.

Genetically determined blood pressure, antihypertensive medications, and risk of intracranial aneurysms and aneurysmal subarachnoid hemorrhage: A Mendelian randomization study

“…4 One cross-sectional study even found CCBs were independently associated with the presence of IAs. 5 Mendelian Randomization (MR) analysis is a complementary approach for assessing the causal effects of risk factors in observational studies using genetic variation. It uses genetic variants (single-nucleotide polymorphisms (SNPs)) as proxies for exposure to certain risk factors to investigate their effects on an outcome of interest.…”

“…Such drug-target mendelian randomization can mimic pharmacological clinical trials and has been used previously to anticipate clinical benefits and adverse effects of therapeutic interventions. 5 Herein, we performed a two-sample MR analysis to investigate the causal effects of genetically determined BP and genetic proxies for antihypertensive drug classes on the risk of IA and SAH.…”

“…4 One cross-sectional study even found CCBs were independently associated with the presence of IAs. 5…”

Genetically Determined Blood Pressure, Antihypertensive Medications, and Risk of Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage: A Mendelian Randomization Study

“…5 One crosssectional study even found CCBs were independently associated with the presence of IAs. 6 Mendelian Randomization(MR) analysis is a complementary approach for assessing the causal effects of risk factors in observational studies using genetic variation. 7 It uses genetic variants (single-nucleotide polymorphisms [SNPs]) as proxies for exposure to certain risk factors to investigate their effects on an outcome of interest.…”

“…5 One cross-sectional study even found CCBs were independently associated with the presence of IAs. 6…”