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Author (up) Lindekleiv, H.; Sandvei, M.S.; Romundstad, P.R.; Wilsgaard, T.; Njolstad, I.; Ingebrigtsen, T.; Vik, A.; Mathiesen, E.B. url  doi
  Title Joint effect of modifiable risk factors on the risk of aneurysmal subarachnoid hemorrhage: a cohort study Type Journal Article
  Year 2012 Publication Stroke; a Journal of Cerebral Circulation Abbreviated Journal Stroke  
  Volume 43 Issue 7 Pages 1885-1889  
  Keywords Adult; Alcohol Drinking/*epidemiology; Cohort Studies; Female; Follow-Up Studies; Humans; Hypertension/complications/*epidemiology; Male; Middle Aged; Norway/epidemiology; Prospective Studies; Risk Factors; Smoking/adverse effects/*epidemiology; Subarachnoid Hemorrhage/*epidemiology/etiology/prevention & control  
  Abstract BACKGROUND AND PURPOSE: The joint effect of risk factors on the risk of aneurysmal SAH (aSAH) has been studied sparsely. METHODS: We examined the potential synergism between cigarette smoking, hypertension, and regular alcohol consumption and the risk of aSAH in a prospective, population-based cohort of participants from the Nord-Trondelag Health Study and the Tromso Study in Norway. Interaction was assessed on additive and multiplicative scales. RESULTS: We identified 122 cases of aSAH over 977 895 person-years of follow-up. Interaction was observed between current smoking and hypertension on the additive scale, (relative excess risk because of interaction, 6.40; 95% CI, 0.88-11.92, adjusted for sex and age). We found no significant interaction between hypertension and regular alcohol consumption or current cigarette smoking and regular alcohol consumption on the additive scale. No significant interaction was detected on the multiplicative scale. CONCLUSIONS: The joint effect of current smoking and hypertension on the risk of aSAH was stronger than was the sum of the independent effects of each factor. Persons at risk of aSAH should be advised of a markedly stronger risk for aSAH with the combination of current smoking and hypertension. In addition, the finding suggests that combining smoking cessation and blood pressure lowering may have an extra risk reduction effect on preventing aSAH.  
  Address Department of Clinical Medicine, Faculty of Health Sciences, University of Tromso, University Hospital of North Norway, N-9037 Tromso, Norway.  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0039-2499 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22517600 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1546  
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