Intracerebral hemorrhage in blacks: Risk factors, subtypes, and outcome

Background and Purpose: Blacks are at a higher risk for intracerebral hemorrhage (ICH) than whites; however, few data are available regarding the demographic and clinical characteristics of ICH among blacks. Methods: We determined the frequency of risk factors, etiologic subtypes, and outcome among consecutive black patients admitted with nontraumatic ICH to a university-affiliated public hospital. Results: The most common risk factors in the 403 black patients with ICH were preexisting hypertension (77%), alcohol use (40%), and smoking (30%). Among the 91 nonhypertensive patients, 21 (23%) were diagnosed with hypertension after onset. Compared with women, men had a younger age of onset (54 versus 60 years; P<.001) and higher frequency of alcohol use (54% versus 22%; P<.001) and smoking (39% versus 17%; P<.001). ICH secondary to hypertension (n=311 and of undetermined etiology (n=73) were the most common subtypes in blacks. Patients aged 65 years and older (compared with those aged 15 to 44 years; P=.001) and women (compared with men; P=.02) were more likely to be dependent at discharge. Conclusions: Primary preventive strategies are required to reduce the high frequency of modifiable risk factors predisposing to ICH in blacks.