We aim to determine the factors in addition to obesity that are associated with an increased risk of Idiopathic Intracranial Hypertension (IIH) using retrospective collected health care data in a population-based cohort.

We used the Cerner Healthfacts Database to identify cases of IIH between 2010 to 2018. All those with a diagnosis of IIH were included, those with secondary causes of raised intracranial pressure such as tumors, hydrocephalus and cerebral venous sinus thrombosis were excluded. Diagnosis codes were used to ascertain IIH cases. We also collected body mass index (BMI), sex, race/ethnicity, geographic distribution, and insurance status. Frequencies and χ2 tests were used to determine the association between variables and BMI.

From 74,364 patients, 17,184 IIH patients were identified. 80% were Female (n=13764), 62.5% were Caucasian (n=10745), and 25.5% were African American (n=4378). Most were from an urban setting (n=14999; 87.3%). The number of patients with IIH increased from 2010 to 2017.

Of the 17,184 patients with IIH, 5,551 had sufficient data to analyze. 20.57% (n=1142) were found to have normal BMI and 63.68% (n=3535) were obese. Being obese and female was significantly associated to IIH χ2 (2, N=5551) =572.79, p=<0.00001. African Americans who were obese (n=1230; 72.06% of the African American) were most likely to develop IIH χ2 (4, N=5551)=53.91, p<0.00001. Patients living in an urban location, (n=3693; 66.5%) where with a BMI of overweight or obese. Overweight and obesity (n=2283; 41.1%) were more common in the South, though the difference was not statistically significant χ2 (3, N=5551)=4.46, p=0.22. 20.5% of patients (n=1141; 20.5%) had commercial insurance, followed by Medicaid (n=780; 14.05%).

We found an increasing incidence of IIH from 2010 to 2017.  Several non-modifiable risk factors were also found to be linked to obesity.