Untreated hypertension leads to increased risk of intracerebral hemorrhage

People with untreated hypertension have a nine-fold higher risk of having an intracerebral hemorrhage regardless of race compared with those who are receiving treatment, according to a prospective, multicenter, case-control study.

Lead researcher Kyle Walsh, MD, an assistant professor of emergency medicine at the University of Cincinnati, presented the results at the American Stroke Association’s International Stroke Conference on Feb. 18.

In the study, which was known as ERICH (Ethnic/Racial Variations of ICH), the researchers enrolled 2,323 adults from 42 centers between September 2010 and June 2015 and matched them with 2,323 controls based on age, sex, race/ethnicity and metropolitan area. The trial included 891 white patients, 833 black patients and 599 Hispanic patients.

They found that 48.3 percent of Hispanics, 43.3 percent of blacks and 33.2 percent of whites had untreated hypertension. After adjusting for medical insurance status, a significantly higher percentage of Hispanics had untreated hypertension compared with whites, although the difference between blacks and whites was not significantly different.

Walsh said in a news release that the average for intracerebral hemorrhage is younger in minorities compared with whites.

Treated and untreated hypertension were significant risk factors for intracerebral hemorrhage in all three races/ethnicities based on multivariate analyses that adjusted for alcohol use, anticoagulation, hypercholesterolemia, education and insurance status. However, untreated hypertension was a substantially greater risk factor than treated hypertension in all three races/ethnicities.

People with untreated hypertension had increased odds of intracerebral hemorrhage of 9.5 times in white patients, 9.7 times in Hispanic patients and 11.1 times in black patients compared with people who did not have hypertension. Among people with hypertension, those who were not treated had a 3.7 times to 5.5 times higher odds of intracerebral hemorrhage compared with those who were treated.

“It’s important to be aware of having high blood pressure in the first place, and once diagnosed, to have it treated appropriately,” Walsh said in a news release.