Cocaine use and hypertension are major risk factors for intracerebral hemorrhage in young African Americans.

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OBJECTIVE: To determine the risk factors for intracerebral hemorrhage (ICH) in African Americans aged 18 to 45 years. African Americans are at a higher risk for ICH than Whites, particularly in the younger age groups. However, few data are available regarding the factors that contribute to the high risk of ICH among younger African Americans. DESIGN: A case-control study. SETTINGS: A university-affiliated public hospital. PARTICIPANTS: One hundred and twenty-two African-American patients admitted with non-traumatic ICH to Grady Memorial Hospital (Atlanta, Ga.) and 366 age- and sex matched African-American controls selected from a nationally representative sample of the civilian, non-institutionalized US population. MAIN OUTCOME MEASURE: Association between ICH and various demographic and clinical factors determined by stepwise logistic regression. RESULTS: Cocaine use (OR 6.1, 95% CI 3.3-11.8), hypertension (OR 5.2, 95% CI 3.2-8.7) and alcohol use (OR 1.9, 95% CI 1.1-3.3) were independently associated with increased risk for ICH. CONCLUSIONS: Cocaine use, hypertension and alcohol use contributed to the high risk of ICH observed in younger African Americans. Primary preventive strategies are required to reduce the high frequency of modifiable risk factors predisposing younger African Americans to ICH.

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