{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:21:41Z","timestamp":1761895301562,"version":"3.38.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2001,2]]},"abstract":"<jats:p><jats:italic>Background and Purpose<\/jats:italic>\u2014The incidence of primary intracerebral hemorrhage (ICH) increases exponentially with age, but the risk factors are not well known. We investigated lifestyle factors, previous diseases, and medications as risk factors for ICH in middle-aged and elderly people.<\/jats:p><jats:p><jats:italic>Methods<\/jats:italic>\u2014We compared 98 consecutive patients with primary ICH between 36 and 90 years of age with 206 community-based control subjects matched for age and sex. Odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for possible confounding variables were calculated by logistic regression.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>\u2014The independent risk factors for ICH were untreated hypertension (OR, 6.95; 95% CI, 3.06 to 15.8), previous ischemic stroke (OR, 3.83; 95% CI, 1.70 to 8.63), epilepsy (OR, 13.8; 95% CI, 2.49 to 76.6), recent strenuous physical exertion (OR, 3.97; 95% CI, 1.95 to 8.10), and a history of epistaxis (OR, 2.92; 95% CI, 1.28 to 6.62). In men, treated hypertension (OR, 2.67; 95% CI, 1.03 to 6.93) was also a significant risk factor. Patients with a history of epistaxis who had used nonsteroidal anti-inflammatory drugs, especially aspirin in high doses, had an increased risk for ICH (adjusted OR of epistaxis, 2.75; 95% CI, 1.11 to 6.81; adjusted OR of aspirin use, 14.7; 95% CI, 2.03 to 106). In addition, there was a significant (<jats:italic>P<\/jats:italic>&lt;0.01) positive interaction between the history of epistaxis and the use of aspirin on the risk for ICH.<\/jats:p><jats:p><jats:italic>Conclusions<\/jats:italic>\u2014Epistaxis is a risk factor for ICH in middle-aged and elderly people, both independently and combined with the use of aspirin. Other independent risk factors are untreated hypertension, previous ischemic stroke, epilepsy, and recent strenuous physical exertion. Epistaxis may be a warning sign of an increased risk for ICH in subjects using aspirin.<\/jats:p>","DOI":"10.1161\/01.str.32.2.399","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:10:52Z","timestamp":1308341452000},"page":"399-404","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Use of Aspirin, Epistaxis, and Untreated Hypertension as Risk Factors for Primary Intracerebral Hemorrhage in Middle-Aged and Elderly People"],"prefix":"10.1161","volume":"32","author":[{"given":"Pertti","family":"Saloheimo","sequence":"first","affiliation":[{"name":"From the Department of Neurology (P.S., M.H.), Oulu University Central Hospital, and the Department of Neurosurgery (S.J.), Helsinki University Central Hospital, Finland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seppo","family":"Juvela","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (P.S., M.H.), Oulu University Central Hospital, and the Department of Neurosurgery (S.J.), Helsinki University Central Hospital, Finland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matti","family":"Hillbom","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (P.S., M.H.), Oulu University Central Hospital, and the Department of Neurosurgery (S.J.), Helsinki University Central Hospital, Finland."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.3.491"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)90804-C"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.11.2020"},{"key":"e_1_3_2_4_2","first-page":"9","volume":"17","year":"1982","unstructured":"Caplan LR, Hier DB, Banks G. Stroke and drug abuse. Curr Concepts Cerebrovasc Dis Stroke. 1982;17:9\u201314.","journal-title":"Curr Concepts Cerebrovasc Dis Stroke"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.9.1558"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(91)90610-A"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198907203210301"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6921.81"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199110313251801"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92233-R"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.54.12.1044"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7186.759"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","first-page":"644","DOI":"10.33588\/rn.27158.97199","volume":"27","year":"1998","unstructured":"Arjona A, Bartolome MT, Zabala JA, Millan I. Intracerebral hemorrhage and treatment with platelet aggregation inhibitors: study of 21 cases. Rev Neurol. 1998;27:644\u2013648.","journal-title":"Rev Neurol"},{"key":"e_1_3_2_14_2","unstructured":"Headache Classification Committee of the International Headache Society. Classification and the diagnostic criteria for headache disorders cranial neuralgia and facial pain. Cephalalgia. 1988;8(suppl 7):1\u201396."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.131.10.1121"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)91579-3"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90061-1"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-198805060-00002"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-201x.1998.00340.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.4.624"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1700930202"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199816090-00018"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.83.5.0820"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1995.tb01595.x"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2000.95227714.x"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90332-5"},{"key":"e_1_3_2_27_2","first-page":"483","volume":"23","year":"1996","unstructured":"Fernandez RR, Cruz JJ, Mata GV. Validation of quality of life questionnaire for critically ill patients. Intensive Care Med. 1996;23:483\u2013484.","journal-title":"Intensive Care Med"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199403000-00011"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410440313"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117094"},{"key":"e_1_3_2_31_2","first-page":"73","volume":"6","year":"1994","unstructured":"Fletcher GF. Exercise in the prevention of stroke. Health Rep. 1994;6:73\u201375.","journal-title":"Health Rep"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.29.10.2049"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.39.4.325"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(91)90074-J"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.1.45"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.17.6.3810710"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.21.11.2237944"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.5.767"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.3.368"},{"key":"e_1_3_2_40_2","first-page":"2213","volume":"49","year":"1994","unstructured":"Lahelma E, Berg M-A, Helakorpi S, Pr\u00e4tt\u00e4l\u00e4 R, Rahkonen O, Puska P. Suomalaisten aikuisten koettu terveydentila ja terveysk\u00e4ytt\u00e4ytyminen, 1979\u201393. Suom L\u00e4\u00e4k\u00e4ril. 1994;49:2213\u20132227.","journal-title":"Suom L\u00e4\u00e4k\u00e4ril"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1988.01860200046014"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1995.tb00071.x"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1994.tb00888.x"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(96)06228-6"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(96)00157-7"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.7.1312"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1161\/hyp.31.6.1223"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.32.2.399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T08:22:45Z","timestamp":1741249365000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.32.2.399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,2]]},"references-count":47,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2001,2]]}},"alternative-id":["10.1161\/01.STR.32.2.399"],"URL":"https:\/\/doi.org\/10.1161\/01.str.32.2.399","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"type":"print","value":"0039-2499"},{"type":"electronic","value":"1524-4628"}],"subject":[],"published":{"date-parts":[[2001,2]]},"assertion":[{"value":"2000-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-10-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}