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. 2016 Apr;6(2):151-6.
doi: 10.21037/qims.2016.01.06.

A higher aneurysmal subarachnoid hemorrhage incidence in women prior to menopause: a retrospective analysis of 4,895 cases from eight hospitals in China

Yì Xiáng J Wáng  1 , Jian He  1 , Lihong Zhang  1 , Yao Li  1 , Lin Zhao  1 , Heng Liu  1 , Lin Yang  1 , Xian Jun Zeng  1 , Jian Yang  1 , Guang Ming Peng  1 , Anil Ahuja  1 , Zheng Han Yang  1
Affiliations

A higher aneurysmal subarachnoid hemorrhage incidence in women prior to menopause: a retrospective analysis of 4,895 cases from eight hospitals in China

Yì Xiáng J Wáng et al. Quant Imaging Med Surg. 2016 Apr.

Abstract

Background: Subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disease. Despite the risk factors, including hypertension, cigarette smoking and alcohol use, are more common in men, aneurysmal SAH belongs to a few diseases which the incidence is higher in women than in men. Sex hormones, especially estrogen, might be protective against this condition. Hormone replacement therapy (HRT) seems to be associated with a reduced risk for aneurysmal SAH. This study aims to know the prevalence of aneurysmal SAH of men and women at different ages.

Methods: The age and gender information of 4,895 case of aneurysmal SAH (3,016 females, 1,879 males) were collected retrospectively from eight institutions in mainland China. The prevalence of aneurysmal SAH of men and women at different ages was analyzed.

Results: The data showed women had a higher incidence of aneurysmal SAH than men starting at late thirties, and men might have a higher incidence of aneurysmal SAH than women only before 37-year-old.

Conclusions: Menopause may not be the only dominant factor causing higher incidence of aneurysmal SAH in women than in men.

Keywords: Physiological gender difference; aneurysmal subarachnoid hemorrhage; cerebral aneurysm; epidemiology.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The incidence sporadic aneurysmal subarachnoid hemorrhage (SAH) vs. age. (A) The incidence of a total of 4,895 cases of sporadic aneurysmal SAH is plotted against their age; (B) y-axis is the value of incidence of females—incidence of males. X-axis: age in years. The results show women have a higher incidence of aneurysmal SAH than men even prior to menopause, and men might have a higher incidence of aneurysmal SAH than women before late thirties.
Figure 2
Figure 2
The incidence sporadic aneurysmal subarachnoid hemorrhage (SAH) vs. age. (A) The incidence of 1,678 cases of sporadic aneurysmal SAH from Nanjing Drum Tower Hospital is plotted against their age; (B) the incidence of 1,497 cases of sporadic aneurysmal SAH from Hebei Medical University is plotted against their age. X-axis: age in years. The results from each center show similar pattern as demonstrated in Figure 1.
See this image and copyright information in PMC

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