- During 1948-2016, the incidence of intracerebral hemorrhage (ICH) rose among adults aged ≥75 years.
Why this matters
- Evidence is mixed regarding a temporal trend.
- Primary ICH during 68-year follow-up:
- 1.25% of patients.
- Incidence rate: 43 cases per 100,000 person-years.
- Age-adjusted incidence rate decreased slightly between 1987-1999 and 2000-2016.
- ICH incidence (per 100,000 person-years) among adults ≥75 years increased over time:
- 1948-1986: 88 cases.
- 1987-1999: 158 cases.
- 2000-2016: 176 cases.
- Anticoagulant use also rose sharply (from 4.4% in 1987-1999 to 13.9% in 2000-2016).
- Incidence rates for both deep and lobar ICH increased with age.
- Risk factors for deep ICH:
- Increasing systolic BP (OR, 1.02; P=.008).
- Increasing diastolic BP (OR, 1.04; P=.01).
- Statin use (OR, 4.07; P = .03).
- Risk factors for lobar ICH:
- Increasing systolic BP (OR, 1.02; P=.002).
- Apolipoprotein E ε4 allele homozygosity (OR, 3.66; P=.02).
- Prospective longitudinal community-based cohort study: 5209 original participants (age, 28-62 years), 5124 offspring participants (age, 5-70 years) from the Framingham Heart Study.
- Main outcome: spontaneous ICH on imaging or pathologic testing.
- Funding: National Institute of Neurological Disorders and Stroke.
- Population was mainly white.
- Data on antithrombotic medications, neuroimaging markers limited.
- Lack of power to assess long-term cognitive effect, medication-risk factor interactions.