Obesity and the risk of intracerebral hemorrhage: The multicenter study on cerebral hemorrhage in Italy

Alessandro Pezzini, Mario Grassi, Maurizio Paciaroni, Andrea Zini, Giorgio Silvestrelli, Licia Iacoviello, Augusto Di Castelnuovo, Elisabetta Del Zotto, Valeria Caso, Paolo Frigio Nichelli, Alessia Giossi, Irene Volonghi, Anna Maria Simone, Alessia Lanari, Paolo Costa, Loris Poli, Roberta Pentore, Francesca Falzone, Massimo Gamba, Andrea MorottiAlfonso Ciccone, Marco Ritelli, Davide Guido, Marina Colombi, Giovanni De Gaetano, Giancarlo Agnelli, Alessandro Padovani

Research output: Contribution to journalArticlepeer-review


Background and Purpose.The effect of obesity on the risk of intracerebral hemorrhage (ICH) may depend on the pathophysiology of vessel damage. To further address this issue, we investigated and quantified the correlations between obesity and obesity-related conditions in the causal pathways leading to ICH. Methods.A total of 777 ICH cases.55 years of age (287 lobar ICH and 490 deep ICH) were consecutively enrolled as part of the Multicenter Study on Cerebral Hemorrhage in Italy and compared with 2083 control subjects by a multivariate path analysis model. Separate analyses were conducted for deep and lobar ICH. Results.Obesity was not independently associated with an increased risk of lobar ICH (odds ratio [OR], 0.76; 95% confidence interval [CI], or deep ICH (OR, 1.18; 95% CI, when compared with control subjects. The path analysis confirmed the nonsignificant total effect of obesity on the risk of lobar ICH (OR, 0.77; 95% CI, but demonstrated a significant indirect effect on the risk of deep ICH (OR, 1.28; 95% CI,, mostly determined by hypertension (OR, 1.07; 95% CI, and diabetes mellitus (OR, 1.04; 95% CI, Obesity was also associated with an increased risk of deep ICH when compared with lobar ICH (OR, 1.62; 95% CI, Conclusions.Obesity increases the risk of deep ICH, mostly through an indirect effect on hypertension and other intermediate obesity-related comorbidities, but has no major influence on the risk of lobar ICH. This supports the hypothesis of different, vessel-specific, biological mechanisms underlying the relationship between obesity and cerebral hemorrhage.

Original languageEnglish
Pages (from-to)1584-1589
Number of pages6
Issue number6
Publication statusPublished - Jun 2013


  • Hemorrhage
  • Obesity
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialised Nursing


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