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Women with High Blood Pressure Who Smoke Have Greater Risk of Aneurysm

Monday, December 16th, 2013

Subarachnoid hemorrhage (SAH) is a cerebrovascular catastrophe that kills 40 to 50 percent of sufferers. A ruptured intracranial aneurysm is the most common cause of SAH. Sometimes, aneurysms are found and treated before they have a chance to rupture. Furthermore, some aneurysms will never rupture. However, there is no way to tell which ones will and which ones won’t. In addition, research now shows that women who smoke and have high blood pressure are more likely to develop SAH. Twenty times more likely!

This discovery is important because it sheds some light on how to decide whether to treat a person with an unruptured intracranial aneurysm. If we know that a female patient with high blood pressure who smokes is significantly more likely to develop SAH than a male patient with normal blood pressure who doesn’t smoke, and intracranial aneurysms are found in both, then it may be that the woman needs to be treated while the man does not. This is an important step in being able to predict which aneurysms are likely to rupture and which aren’t.

The study also revealed three previously unknown risk factors for SAH: elevated cholesterol levels in men, and maternal history of stroke and previous heart attack in either gender. These results show that the risk factors for SAH appear to be similar to the risk factors for other cardiovascular diseases.

It is already known that lifestyle risk factors have a significant impact on the life expectancy of a person who has survived SAH. Now, it is becoming clear that those same risk factors increase the risk of SAH in the first place. Therefore, quitting smoking and taking steps to lower high blood pressure are especially important in both preventing SAH and increasing life expectancy if it does occur.

Of course, this is just one more item to add to the list of reasons why you should quit smoking. Smoking is a well-known health risk that people can choose not to expose themselves to. Cigarettes contain over 4000 chemicals, at least 400 of which are known toxic substances.

Among the most harmful products in cigarette smoke are tar, which is a carcinogen; nicotine, which is addictive and is thought to increase cholesterol levels and carbon monoxide, which replaces oxygen in your bloodstream. An individual’s overall health risk from smoking depends upon a number of factors, including how much the individual smokes, whether the cigarette has a filter, and how the tobacco has been prepared. More research is needed before it will be clear whether these same factors affect a person’s SAH risk.

As for hypertension, it is known to be potentially damaging to several body systems, including the arteries, heart, brain, and kidneys. Talk to your doctor about your blood pressure and/or smoking to find solutions for lowering your blood pressure, helping you quit smoking, or both.

– Yvonne S. Thornton, M. D., M. P. H.