We sought to compare risk factors for intracerebral hemorrhage (ICH) across White, Black, and Hispanic case-control groups, stratified by lobar vs. non-lobar location.

The ERICH Study is a prospective, case-control study of ICH among Whites, Blacks, and Hispanics recruited from 41 sites from 2010-2015, with approximately 1,000 case-control pairs in each race/ethnic group. Information was obtained by standardized interview and genotyping. Separately for lobar and non-lobar ICH, multivariate logistic regression was computed to test for independent risk factors and their interaction with race/ethnicity.

Compared to Whites, ICH cases among Blacks and Hispanics were younger and had a higher proportion of non-lobar ICH. For lobar ICH, these factors were associated across all three race/ethnic groups:  untreated hypertension, sleep apnea, ischemic stroke, anticoagulation use, Apolipoprotein E2 (ApoE2), lower body mass index (BMI), lower education achievement, lack of medical insurance, and reported stress.  Moderate alcohol use was associated with decreased risk. Compared to the other race/ethnic groups, Blacks had a significantly greater risk associated with anticoagulation use, while Whites had significantly greater risk associated with Apolipoprotein E4. 

For non-lobar ICH, these factors were associated across all three race/ethnic groups:  untreated hypertension, sleep apnea, ischemic stroke, chronic kidney disease, anticoagulation use, sympathomimetic use, no history of high cholesterol or migraine, lack of ApoE2, lower BMI, heavy or no alcohol use, lower education achievement, lack of medical insurance and reported stress. Compared to the other race/ethnic groups, Hispanics had a significantly greater risk associated with heavy alcohol use.

Once stratified by location, risk factors for ICH were largely similar across race/ethnic groups but with a few key exceptions. Differences by proportion will be reported.