{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:30:10Z","timestamp":1784867410979,"version":"3.55.0"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Hemorrhagic stroke (HS), including intracerebral and subarachnoid hemorrhage (ICH and SAH), has high mortality and morbidity. We assessed the 24\u2010year trends in incidence, prestroke risk factors, medications, and demographic patterns in a multiracial and multiethnic population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We used 1995 to 2018 data from the South London Stroke Register. The annual incidence rates of HS, ICH, and SAH were standardized to the 2011 England and Wales population and stratified by age, sex, and race or ethnicity. Incidence trends were assessed using Cochran\u2013Armitage tests and Poisson regression. Multiple logistic regressions (with imputed data) assessed shifts in prestroke variables across demographics.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Among 811 patients with ICH and 308 patients with SAH, HS incidence declined by 52% (ICH), 58% (SAH), and 53% overall all demographic groups between 1995 to 2000 and 2013 to 2018 but plateaued or slightly increased from 2007 to 2018. HS incidence per 100\u2009000\/year was 19.26 (ICH, 15.35 [95% CI, 13.66\u201317.19]; SAH, 3.91 [95% CI, 3.07\u20134.88)] in 2007\u20132012, and 19.38 (ICH, 15.04 [95% CI, 13.36\u201316.86]; SAH, 4.34 [95% CI, 3.45\u20135.35]) in 2013 to 2018. Antiplatelet use declined (OR, 0.10 [95% CI, 0.02\u20130.44]), and cholesterol\u2010lowering drugs (OR, 7.8 [95% CI, 3.41\u201317.81]) and anticoagulants (OR, 5.54 [95% CI, 2.77\u201311.07]) increased. Diabetes (OR, 1.92 [95% CI, 1.11\u20133.32]), hypercholesterolemia (OR, 7.8 [95% CI, 3.41\u201317.81]), and atrial fibrillation (OR, [95% CI, 2.87 1.55\u20135.3]) increased, and hypertension remained static (OR, 0.89 [95% CI, 0.6\u20131.32]). Smoking and alcohol use substantially decreased (OR, 0.37 [95% CI, 0.24\u20130.57]; OR, 0.28 [95% CI, 0.17\u20130.48], respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">HS (ICH and SAH) incidence declined over 50% in 25\u2009years, mainly in the first 12\u2009years. Medication and prestroke comorbidities only partly explain this reduction. Improved prevention and reduced smoking and drinking may have contributed further.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.040371","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T11:28:06Z","timestamp":1754998086000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Long\u2010Term Trends in Incidence and Risk Factors for Hemorrhagic Stroke Subtypes Over 24\u2009Years: The South London Stroke Register"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-0749","authenticated-orcid":false,"given":"Xianqi","family":"Li","sequence":"first","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-7766","authenticated-orcid":false,"given":"Lu","family":"Liu","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1539-8253","authenticated-orcid":false,"given":"Ajay","family":"Bhalla","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]},{"name":"Guy\u2019s and St Thomas NHS Foundation Trust","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D. 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