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Rautalin I, Kaprio J, Ingebrigtsen T, et al. Obesity Does Not Protect From Subarachnoid Hemorrhage: Pooled Analyses of 3 Large Prospective Nordic Cohorts. Stroke. 2021;STROKEAHA121034782doi: 10.1161/STROKEAHA.121.034782.
Rautalin, I., Kaprio, J., Ingebrigtsen, T., Jousilahti, P., Løchen, M. L., Romundstad, P. R., Salomaa, V., Vik, A., Wilsgaard, T., Mathiesen, E. B., Sandvei, M., & Korja, M. (2021). Obesity Does Not Protect From Subarachnoid Hemorrhage: Pooled Analyses of 3 Large Prospective Nordic Cohorts. Stroke, STROKEAHA121034782. https://doi.org/10.1161/STROKEAHA.121.034782
Rautalin, Ilari, et al. "Obesity Does Not Protect From Subarachnoid Hemorrhage: Pooled Analyses of 3 Large Prospective Nordic Cohorts." Stroke vol. (2021): STROKEAHA121034782. doi: https://doi.org/10.1161/STROKEAHA.121.034782
Rautalin I, Kaprio J, Ingebrigtsen T, Jousilahti P, Løchen ML, Romundstad PR, Salomaa V, Vik A, Wilsgaard T, Mathiesen EB, Sandvei M, Korja M. Obesity Does Not Protect From Subarachnoid Hemorrhage: Pooled Analyses of 3 Large Prospective Nordic Cohorts. Stroke. 2021 Nov 10;STROKEAHA121034782. doi: 10.1161/STROKEAHA.121.034782. Epub 2021 Nov 10. PMID: 34753302.
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Stroke. 2021 Nov 10;STROKEAHA121034782. doi: 10.1161/STROKEAHA.121.034782. Epub 2021 Nov 10.

Obesity Does Not Protect From Subarachnoid Hemorrhage: Pooled Analyses of 3 Large Prospective Nordic Cohorts.

Stroke

Ilari Rautalin, Jaakko Kaprio, Tor Ingebrigtsen, Pekka Jousilahti, Maja-Lisa Løchen, Pål Richard Romundstad, Veikko Salomaa, Anne Vik, Tom Wilsgaard, Ellisiv B Mathiesen, Marie Sandvei, Miikka Korja

Affiliations

  1. Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Finland (I.R., M.K.).
  2. Department of Public Health, University of Helsinki, Finland (I.R., J.K.).
  3. Institute for Molecular Medicine FIMM, Helsinki, Finland (J.K.).
  4. Department of Clinical Medicine, Faculty of Health Sciences (T.I.).
  5. Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø. (T.I.).
  6. Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland (P.J., V.S.).
  7. Department of Community Medicine, UiT the Arctic University of Norway, Tromsø. (M.-L.L., T.W.).
  8. Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway. (P.R.R., M.S.).
  9. Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. (A.V.).
  10. Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Norway (A.V.).
  11. Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø. (E.B.M.).
  12. Department of Neurology, University Hospital of North Norway, Tromsø. (E.B.M.).
  13. The Cancer Clinic, St Olav's University Hospital, Trondheim, Norway (M.S.).

PMID: 34753302 DOI: 10.1161/STROKEAHA.121.034782

Abstract

BACKGROUND AND PURPOSE: Several population-based cohort studies have related higher body mass index (BMI) to a decreased risk of subarachnoid hemorrhage (SAH). The main objective of our study was to investigate whether the previously reported inverse association can be explained by modifying effects of the most important risk factors of SAH-smoking and hypertension.

METHODS: We conducted a collaborative study of three prospective population-based Nordic cohorts by combining comprehensive baseline data from 211 972 adult participants collected between 1972 and 2012, with follow-up until the end of 2018. Primarily, we compared the risk of SAH between three BMI categories: (1) low (BMI<22.5), (2) moderate (BMI: 22.5-29.9), and (3) high (BMI≥30) BMI and evaluated the modifying effects of smoking and hypertension on the associations.

RESULTS: We identified 831 SAH events (mean age 62 years, 55% women) during the total follow-up of 4.7 million person-years. Compared with the moderate BMI category, persons with low BMI had an elevated risk for SAH (adjusted hazard ratio [HR], 1.30 [1.09-1.55]), whereas no significant risk difference was found in high BMI category (HR, 0.91 [0.73-1.13]). However, we only found the increased risk of low BMI in smokers (HR, 1.49 [1.19-1.88]) and in hypertensive men (HR, 1.72 [1.18-2.50]), but not in nonsmokers (HR, 1.02 [0.76-1.37]) or in men with normal blood pressure values (HR, 0.98 [0.63-1.54]; interaction HRs, 1.68 [1.18-2.41],

CONCLUSIONS: Smoking and hypertension appear to explain, at least partly, the previously reported inverse association between BMI and the risk of SAH. Therefore, the independent role of BMI in the risk of SAH is likely modest.

Keywords: blood pressure; body mass index; hypertension; smoking; subarachnoid hemorrhage

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