Current use of certain antihypertensives, statins, and antidiabetic drugs may lower the risk for aneurysmal subarachnoid hemorrhage, whereas anticoagulants and psychotropic drugs may increase risk.
A recent study investigated the association using the Secure Anonymised Information Linkage databank to conduct a comprehensive drug-wide association study from 2000 to 2020.
Published in Neurology, researchers identified 4,879 cases of aSAH, each matched with 9 controls based on age, sex, and year of database entry. The researchers evaluated the use of 205 commonly prescribed drugs, categorizing drug exposure into three temporal windows: current (within 3 months), recent (3–12 months), and past (over 12 months) relative to the aSAH index date.
Key findings included:
- Lisinopril: Current use was associated with a reduced risk for aSAH (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.44–0.90), while recent use was linked to an increased risk (OR 1.30, 95% CI 0.61–2.78).
- Amlodipine: The treatment showed a decreased risk for current use (OR 0.82, 95% CI 0.65–1.04) and an increased risk for recent use (OR 1.61, 95% CI 1.04–2.48).
- Simvastatin, metformin, tamsulosin: Current use indicated a decreased risk for aSAH (simvastatin OR 0.78, 95% CI 0.64–0.96; metformin OR 0.58, 95% CI 0.43–0.78; tamsulosin OR 0.55, 95% CI 0.32–0.93).
- Warfarin, venlafaxine, prochlorperazine, co-codamol: These medications were linked to an increased risk for aSAH with current use (warfarin OR 1.35, 95% CI 1.02–1.79; venlafaxine OR 1.67, 95% CI 1.01–2.75; prochlorperazine OR 2.15, 95% CI 1.45–3.18; co-codamol OR 1.31, 95% CI 1.10–1.56).
The study provided Class III evidence that specific commonly prescribed medications are associated with varying risks of aSAH.
Full author disclosures can be found in the original study.