Cerebral arterial aneurysm formation and rupture in 20,767 elderly patients: Hypertension and other risk factors

C. L. Taylor, Z. Yuan, W. R. Selman, R. A. Ratcheson, A. A. Rimm

Research output: Contribution to journalArticle

159 Scopus citations

Abstract

Cerebral arterial aneurysms are common in the general population and their rupture is a catastrophic event. Considerable uncertainty remains concerning the conditions that predispose individuals to aneurysm formation or rupture. The role of systemic hypertension in aneurysm formation anti rupture has been especially controversial. Demographic variables have rarely been addressed because of the small sample sizes in previous studies. The authors describe the demographics and prevalence of hypertension in 20,767 Medicare patients with an unruptured aneurysm and compare these to a random sample of the hospitalized Medicare population. The prevalence of hypertension in patients with unruptured aneurysms was 43.2% compared with 34.4% in the random sample. Patients who survived their initial hospitalization were separated into two groups: those with an unruptured cerebral aneurysm as the primary diagnosis and those with an unruptured cerebral aneurysm as a secondary diagnosis. Follow-up data for 18,119 patients were examined to determine the risk of subarachnoid hemorrhage (SAH) associated with age, gender, race, hypertension, insulin-dependent diabetes mellitus, and surgical treatment. For patients with an unruptured cerebral aneurysm as the primary diagnosis, hypertension was found to be a significant risk factor for future SAH (risk ratio: 1.46, 95% confidence interval (CI): 1.01-2.11), whereas surgical treatment (risk ratio: 0.29, 95% CI: 0.09-0.97) had a significant protective effect. Advancing age had a small hut significant protective effect in both groups. Elderly patients identified with unruptured aneurysms are more likely to have coexisting hypertension than the general hospitalized population. In elderly patients hospitalized with an unruptured cerebral aneurysm as their primary diagnosis, hypertension is a risk factor for subsequent SAH, whereas surgical treatment is a protective factor against SAH.

Original languageEnglish (US)
Pages (from-to)812-819
Number of pages8
JournalJournal of neurosurgery
Volume83
Issue number5
DOIs
StatePublished - Jan 1 1995
Externally publishedYes

Keywords

  • cerebral aneurysm
  • hypertension
  • risk factor subarachnoid hemorrhage
  • stroke

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Cerebral arterial aneurysm formation and rupture in 20,767 elderly patients: Hypertension and other risk factors'. Together they form a unique fingerprint.

  • Cite this