A causal relationship between long-term statin use and the risk of intracerebral hemorrhage (ICH) remains uncertain. We investigated the association with statin use before hospital admission for ICH in a Danish population–based, nationwide case-control study.

We used the Danish Stroke Registry to identify all patients aged 45 years or older with a first-ever ICH between 2005 and 2018. Patients with ICH were matched for age, sex, and calendar year to controls selected from the general population. A medication registry with information on all dispensed prescriptions at community pharmacies in Denmark since 1995 was used to ascertain previous statin exposure that was classified for recency, duration, and intensity. Using conditional regression and adjusting for potential confounders, we calculated adjusted odds ratios (aORs) and corresponding 95% CIs for the risk of ICH.

The study population consisted of 16,235 patients with ICH and 640,943 controls. Current statin use (cases 25.9% vs controls 24.5%; aOR 0.74, 95% CI, 0.71–0.78) and a longer duration of current statin use (<1 year: aOR 0.86; 95% CI, 0.81–0.92; ≥1 to <5 years: aOR 0.72; 95% CI, 0.68–0.76; ≥5 to <10 years: aOR 0.65; 95% CI, 0.60–0.71; ≥10 years of use, 0.53; 95% CI 0.45–0.62; p for trend <0.001) were associated with a lower risk of ICH. Similar treatment duration relationships were found in analyses stratified by statin use intensity (high-intensity therapy: <1 year of use: aOR 0.78; 95% CI, 0.66–0.93; ≥10 years of use: aOR 0.46; 95% CI 0.33–0.65; p for trend 0.001).

We found that a longer duration of statin use was associated with a lower risk of ICH.

This study provides Class II evidence that current statin use and a longer duration of statin use are each associated with a lower risk of ICH.

长期使用他汀类药物与脑出血（ICH）风险之间的因果关系仍不确定。我们在一项基于丹麦人群的全国病例对照研究中调查了因脑出血入院前使用他汀类药物与他汀类药物的关联。

我们使用丹麦中风登记处来识别 2005 年至 2018 年间所有 45 岁或以上首次发生 ICH 的患者。将 ICH 患者的年龄、性别和日历年份与从一般人群中选择的对照进行匹配。药物登记处包含自 1995 年以来丹麦社区药房所有配发处方的信息，用于确定以前的他汀类药物暴露情况，并按新近度、持续时间和强度进行分类。使用条件回归并调整潜在的混杂因素，我们计算了 ICH 风险的调整优势比 (aOR) 和相应的 95% CI。

研究人群包括 16,235 名 ICH 患者和 640,943 名对照者。当前他汀类药物使用情况（病例 25.9% vs 对照组 24.5%；aOR 0.74，95% CI，0.71–0.78）和当前他汀类药物使用时间较长（<1 id=7>p 为趋势 <0 id=8>p 为趋势0.001）。

我们发现，较长时间使用他汀类药物与较低的脑出血风险相关。

这项研究提供了 II 类证据，表明当前使用他汀类药物和较长时间使用他汀类药物均与较低的 ICH 风险相关。