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Incidents of Subarachnoid Hemorrhage on the Rise, Especially in Black Americans
Incidences of nontraumatic subarachnoid hemorrhage (SAH) have increased in the United States over the last decade in middle-aged and elderly men, women, and are disproportionately higher in Black patients, according to new study results published in Neurology.
“The incidence of this type of stroke is disproportionately higher, and increasing, in Black people, leading to a widening of the racial incidence gap,” said corresponding author Fadar Oliver Otite, MD, ScM, SUNY Upstate Medical University in Syracuse, NY.
While subarachnoid hemorrhage can be caused by aneurysm rupture, high blood pressure, or trauma, researchers looked only at non-trauma cases for the study.
Researchers utilized the State Inpatients Databases of New York and Florida to identify all new cases of SAH from 2007 to 2017 (n-39,475), then combined the tally with Census data to calculate the incident rate. Joinpoint regression was then used to calculate annual rates and compare rates over time for men, women, age groups, races, and ethnicities.
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Over the course of the 10-year period under examination, the overall average incidence of SAH was 11 cases per 100,000 people. Further, the average incidence rate increased over time by 0.7% on average per year. Rates were higher among women, with 13 cases per 100,000 and lower in men with 10 cases. In middle-aged men, the incidence rate was 4 per 100,000, while men aged 65 and older averaged 22 cases, indicating SAH incidence increased with age.
When looking at race and ethnicity, incidence of SAH was higher in Black people, with an average of 15 cases per 100,000 people, while non-Hispanic white people averaged 10 cases per 100,000 people. The incidence rate in Black people also increased over time by 1.8% per year, while rates for Hispanic, Asian, and non-Hispanic white people held steady.
“Previous studies have found Black people develop high blood pressure younger and are more likely to have uncontrolled high blood pressure than non-Hispanic white people, so expanding efforts to control blood pressure may help reduce rates,” Otite said. “The causes also likely extend to socioeconomic factors including structural racism. Tackling racial disparities will require multifaceted interventions targeted at stroke risk factors and socioeconomic inequity.”
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