J Neurol Neurosurg Psychiatry 83:541-542 doi:10.1136/jnnp-2011-301147
  • Cerebrovascular disease
  • Research paper

Additional risk of hypertension and smoking for aneurysms in people with a family history of subarachnoid haemorrhage

  1. Gabriel J E Rinkel1
  1. 1Utrecht Stroke Centre, Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
  2. 2The Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dennis Nieuwkamp, Department of Neurology, C03.236, University Medical Centre Utrecht, PO Box 85500, 3584 CX Utrecht, The Netherlands; d.nieuwkamp{at}
  1. Contributors AA and GJER designed the study. IR and DJN did the literature search. IR and DJN extracted the data. IR, DJN, AA and GJER analysed and interpreted the data. IR wrote the first draft of the manuscript. AA and GJER supervised the study. All authors contributed to subsequent versions of the manuscript.

  • Received 9 August 2011
  • Revised 8 November 2011
  • Accepted 24 January 2012
  • Published Online First 15 March 2012


Background Smoking and hypertension increase the risk of aneurismal subarachnoid haemorrhage (SAH) two to threefold whereas a familial predisposition increases the risk sixfold. We assessed the additional risk of smoking and hypertension for the presence of an intracranial aneurysm (IA) in first-degree relatives of patients with familial SAH.

Methods We studied first-degree relatives of patients with familial SAH who were screened for the presence of aneurysms. RRs with corresponding 95% CIs for the risk of IA were calculated for smoking and hypertension.

Results The RRs were 1.5 (95% CI 0.7 to 3.2) for smoking, 1.9 (95% CI 1.0 to 3.7) for hypertension and 2.7 (95% CI 1.4 to 5.3) for smoking plus hypertension. The increased RR for hypertension was found in both women and men, but the increased RR for smoking was found in women only.

Conclusion The extent of the increased risk of smoking and hypertension for the presence of IA in first-degree relatives of patients with familial SAH is similar to that in patients without familial predisposition. Risk factor profiles should be included in future genetic studies.


  • Funding Partly funded by a grant from the Netherlands Organisation for Health Research and Development (grant number 920-03-299) to DJN.

  • Competing interests None.

  • Ethics approval To our knowledge approval of an Ethics Committee was not necessary for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Dataset available from the corresponding author at d.nieuwkamp{at} Consent was not obtained, but the presented data are anonymised and risk of identification is low.

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