Regular medication as a risk factor for intracranial aneurysms: A comparative case–control study. (March 2023)

• Record Type: Journal Article
• Authors: Jabbarli, Ramazan; Darkwah Oppong, Marvin; Chihi, Mehdi; Dinger, Thiemo Florin; Said, Maryam; Rodemerk, Jan; Dammann, Philipp; Schmidt, Börge; Deuschl, Cornelius; Guberina, Nika; Wrede, Karsten H.; Sure, Ulrich
• Is Part Of: European stroke journal. Volume 8:Number 1(2023)
• Page Start: 251
• Page End: 258
• Publication Date: 2023-03
• Subjects: intracranial aneurysm -- subarachnoid hemorrhage -- risk -- medication -- comorbidity; Cerebrovascular disease -- Periodicals; 616.8005
• DOI: 10.1177/23969873221129080
• Languages: English
• ISSNs: 2396-9873

Abstract

Background: Previous medical history strongly contributes to the genesis of intracranial aneurysms (IA). A possible impact of regular medication on the occurrence of abdominal aortic aneurysms has been reported. Aim: To evaluate the value of regular medication on the risk of development and rupture of IA. Methods: Data on medication use and related comorbidities were obtained from the institutional IA registry. A 1:1 age- and sex-matched patient sample was collected from the population-based Heinz Nixdorf Recall Study with individuals from the same area. Results: In the analysis comparing IA cohort ( n = 1960) with the matched normal population ( n = 1960), the use of statins (adjusted odds ratio, 1.34 [95% confidence interval 1.02–1.78]), antidiabetics (1.46 [1.08–1.99]), and calcium channel blockers (1.49 [1.11–2.00]) was independently associated with higher risk of IA, whereas uricostatics (0.23 [0.14–0.38]), aspirin (0.23 [0.13–0.43]), beta-blockers (0.51 [0.40–0.66]), and angiotensin-converting enzyme inhibitors (0.38 [0.27–0.53]) were related to lower risk of IA. In the multivariable analysis within the IA cohort ( n = 2446), SAH patients showed higher drug exposure with thiazide diuretics (2.11 [1.59–2.80]), but lower prevalence of remaining antihypertensive medication—beta-blockers (0.38 [0.30–0.48]), calcium channel blockers (0.63 [0.48–0.83]), angiotensin-converting enzyme inhibitors (0.56 [0.44–0.72]), and angiotensin-1 receptor blockers (0.33 [0.24–0.45]). Patients with ruptured IA were less likely to be treated with statins (0.62 [0.47–0.81]), thyroid hormones (0.62 [0.48–0.79]), and aspirin (0.55 [0.41–0.75]). Conclusions: Regular medication might impact the risks related to the development and rupture of IA. Further clinical trials are required to clarify the effect of regular medication on IA genesis.