OBJECTIVE: To determine the risk factors for intracerebral hemorrhage (ICH) in 
African Americans aged 18 to 45 years. African Americans are at a higher risk 
for ICH than Whites, particularly in the younger age groups. However, few data 
are available regarding the factors that contribute to the high risk of ICH 
among younger African Americans.
DESIGN: A case-control study.
SETTINGS: A university-affiliated public hospital.
PARTICIPANTS: One hundred and twenty-two African-American patients admitted with 
non-traumatic ICH to Grady Memorial Hospital (Atlanta, Ga.) and 366 age- and sex 
matched African-American controls selected from a nationally representative 
sample of the civilian, non-institutionalized US population.
MAIN OUTCOME MEASURE: Association between ICH and various demographic and 
clinical factors determined by stepwise logistic regression.
RESULTS: Cocaine use (OR 6.1, 95% CI 3.3-11.8), hypertension (OR 5.2, 95% CI 
3.2-8.7) and alcohol use (OR 1.9, 95% CI 1.1-3.3) were independently associated 
with increased risk for ICH.
CONCLUSIONS: Cocaine use, hypertension and alcohol use contributed to the high 
risk of ICH observed in younger African Americans. Primary preventive strategies 
are required to reduce the high frequency of modifiable risk factors 
predisposing younger African Americans to ICH.