To investigate whether the inflammatory marker Creactive protein (CRP) is associated with hematoma volume in patients with hypertensive intracerebral hemorrhage (HICH) who have lived longterm in high-altitude areas.

A retrospective analysis was conducted on 120 HICH patients hospitalized to People's Hospital of Xizang Autonomous Region from April 2020 to March 2023, all of whom had resided at high altitude for ≥5 years. Hematoma volume was calculated using a standard formula, while demographic characteristics, medical history, and laboratory data were extracted from medical records. A generalized linear regression model was employed to analyze the correlation between hematoma volume and serum CRP levels, adjusting for age, sex, blood glucose, smoking, and alcohol consumption.

The mean age of onset was (65.38±7.46) years, with 116 (96.67%) Tibetan patients and 77 (64.17%) males. The hematoma volume was 25.70 (10.80, 49.30) mL, and the serum CRP level was 3.20 (1.18, 8.83) mg/L. Univariate analysis revealed a negative correlation between hematoma volume and age (β=−0.87, P=0.010) and a positive correlation with serum CRP level (β=0.21, P=0.011). After adjusting for confounders, multivariate analysis still demonstrated a positive association between hematoma volume and serum CRP level (β=0.19, P=0.023), as well as a negative correlation with age (β=−0.85, P=0.026).

Elevated serum CRP levels are associated with increased hematoma volume in long-term high-altitude HICH patients. These findings highlight the importance of strengthening hypertension control in middleaged populations in highaltitude regions to reduce the incidence and poor outcomes of HICH.