Worldwide, almost 500,000 individuals develop a SAH caused by an aneurysm each year, with almost two-thirds of these in low- and middle-income countries.[6]Hughes JD, Bond KM, Mekary RA, et al. Estimating the global incidence of aneurysmal subarachnoid hemorrhage: a systematic review for central nervous system vascular lesions and meta-analysis of ruptured aneurysms. World Neurosurg. 2018 Jul;115:430-447.e7.
https://www.doi.org/10.1016/j.wneu.2018.03.220
http://www.ncbi.nlm.nih.gov/pubmed/29649643?tool=bestpractice.com
The global incidence of SAH declined between 1980 and 2010 which may parallel the global decreases in blood pressure and smoking prevalence.[7]Claassen J, Park S. Spontaneous subarachnoid haemorrhage. Lancet. 2022 Sep 10;400(10355):846-62.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9987649
http://www.ncbi.nlm.nih.gov/pubmed/35985353?tool=bestpractice.com
However, a large variation in SAH incidence exists according to region, age, and sex.
The incidence in the US is between 6 and 8 cases out of 100,000 per year.[6]Hughes JD, Bond KM, Mekary RA, et al. Estimating the global incidence of aneurysmal subarachnoid hemorrhage: a systematic review for central nervous system vascular lesions and meta-analysis of ruptured aneurysms. World Neurosurg. 2018 Jul;115:430-447.e7.
https://www.doi.org/10.1016/j.wneu.2018.03.220
http://www.ncbi.nlm.nih.gov/pubmed/29649643?tool=bestpractice.com
[8]Linn FH, Rinkel GJ, Algra A, et al. Incidence of subarachnoid hemorrhage: role of region, year, and rate of computed tomography: a meta-analysis. Stroke. 1996 Apr;27(4):625-9.
http://www.ncbi.nlm.nih.gov/pubmed/8614919?tool=bestpractice.com
A higher incidence in Hispanic populations compared with in non-Hispanic populations has also been noted in some areas of the US.[9]Bruno A, Qualls C. Risk factors for intracerebral and subarachnoid hemorrhage among Hispanics and non-Hispanic whites in a New Mexico community. Neuroepidemiology. 2000 Jul-Aug;19(4):227-32.
http://www.ncbi.nlm.nih.gov/pubmed/10859503?tool=bestpractice.com
Some countries have seen increases in the incidence of SAH. In Japan, the incidence of SAH increased between 1980 and 2010, especially in women older than 55 years.[10]Etminan N, Chang HS, Hackenberg K, et al. Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis. JAMA Neurol. 2019 May 1;76(5):588-97.
https://www.doi.org/10.1001/jamaneurol.2019.0006
http://www.ncbi.nlm.nih.gov/pubmed/30659573?tool=bestpractice.com
Incidence also increases with age. The average age at onset is between 50 and 55 years.[1]Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med. 2006 Jan 26;354(4):387-96.[11]Kassell NF, Torner JC, Haley EC Jr, et al. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: overall management results. J Neurosurg. 1990 Jul;73(1):18-36.
http://www.ncbi.nlm.nih.gov/pubmed/2191090?tool=bestpractice.com
[12]Kassell NF, Torner JC, Jane JA, et al. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: surgical results. J Neurosurg. 1990 Jul;73(1):37-47.
http://www.ncbi.nlm.nih.gov/pubmed/2191091?tool=bestpractice.com
SAH is 1.6 times more common in women than in men, and 2.1 times more common in black people than in white people.[8]Linn FH, Rinkel GJ, Algra A, et al. Incidence of subarachnoid hemorrhage: role of region, year, and rate of computed tomography: a meta-analysis. Stroke. 1996 Apr;27(4):625-9.
http://www.ncbi.nlm.nih.gov/pubmed/8614919?tool=bestpractice.com
[13]Broderick JP, Brott T, Tomsick T, et al. The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with whites. N Engl J Med. 1992 Mar 12;326(11):733-6.
http://www.ncbi.nlm.nih.gov/pubmed/1738378?tool=bestpractice.com
SAH accounts for about 5% of all strokes.[14]Adams HP, Davis P. Aneurysmal subarachnoid hemorrhage. In: Mohr JP, Choi D, Grotta J, et al, eds. Stroke: pathophysiology, diagnosis and management. London: Churchill Livingstone; 2004:377-96.