Statin use is associated with reduced risk of incident intracerebral hemorrhage: A prospective population-based cohort study.

Background: The association between statin use and the risk of incident intracerebral hemorrhage (ICH) remains controversial, with concerns about a potential increased risk of ICH among statin users.

Aims: This study aimed to investigate the association between statin use and incident ICH in the general population.

Methods: This prospective cohort study utilized data from UK Biobank. Cox proportional regression models were employed to estimate hazard ratios (HRs) for the association between statin use and incident ICH in both unmatched and propensity score-matched (PSM) cohorts, adjusting for sociodemographic characteristics, lifestyle factors, comorbidities, and concurrent medication use.

Results: A total of 421,444 participants were included in the final analysis, with a median age of 58.0 years (interquartile range [IQR]: 50.0-63.0), and 53.9% were female. At baseline, 69,272 individuals reported regular statin use. Over a median follow-up period of 12.75 years (IQR: 11.30-14.21), 1533 participants (0.4%) experienced incident ICH. Multivariate Cox regression analyses showed that statin use was significantly associated with a reduced risk of ICH in the fully adjusted model (aHR 0.77; 95% CI 0.66-0.90). This association was significant among individuals without a history of coronary artery disease, stroke or transient ischemic attack (aHR 0.75; 95% CI 0.63-0.89). Potential interaction effects were identified between statin use and age (p for interaction = 0.027 in the total cohort), waist-to-hip ratio, and low-density lipoprotein cholesterol levels (p for interaction = 0.025 and 0.062, respectively, in the PSM cohort) in relation to ICH risk.

Conclusion: In this large population-based study, statin use was associated with a reduced risk of incident ICH, providing further evidence for the long-term safety of statin therapy with respect to ICH risk in the general population and across diverse subgroups.Data access statement:UK Biobank database is available on application by approved researchers.