Study reveals concerning trend of brain bleeds in older adults

Boston – Accounting for 10-15 percent of all strokes, intracerebral hemorrhage – caused by bleeding throughout the brain and its ventricles – has the highest mortality rate of all stroke types. While previous research has shown decreased incidence of other types of stroke in the last several decades, there has not been enough consistent data on intracerebral hemorrhage for a similar conclusion.

According to a new analysis of data from the Framingham Heart Study, a decades-long research project of the National Heart, Lung and Blood Institute, incidence of intracerebral hemorrhage has stabilized among most age groups but has increased among those older than 75 years old. The unexpected trend was reported by study first author Vasileios-Arsenios Lioutas, MD, a neurologist at Beth Israel Deaconess Medical Center, and colleagues in JAMA Neurology.

The neuroscientists reviewed Framingham Heart Study data from 1948 and 2016, accounting for the changes in diagnostic and preventative care practices over time. The team noticed that, in addition to incidence of intracerebral hemorrhage increasing in participants older than 75 years, the use of blood thinners tripled during the same time period, providing a possible link.

“While we saw a temporal association between the use of anticoagulant medications and increased risk of intracerebral hemorrhage, these medications are crucially important in preventing more common types of strokes,” said Lioutas, who is also an assistant professor of neurology at Harvard Medical School. “One of the possible explanations for why we saw more brain bleeds among older Framingham participants is that anticoagulant medications helped prolong their life expectancy, leading them to be at risk for hemorrhage later in life.”

The team notes that more research and preventative efforts are needed to better understand and stabilize the trends among all age groups.

In addition to Lioutas, study authors include Alexa S. Beiser, Hugo J. Aparicio, Jayandra J. Himali, Magdy Selim, Jose Rafael Romero and Sudha Seshadri.

This research was supported by the National Institute of Neurological Disorders and Stroke, the National Institute on Aging, and the National Heart, Lung and Blood Institute.