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Fibroblast Growth Factor 23 and Incidence of Subarachnoid Hemorrhage: Nested Case-Control Study. BACKGROUND AND PURPOSE: Fibroblast growth factor 23 (FGF23) is a hormone with regulatory effects on mineral metabolism and arterial calcification. We aimed to study the association between FGF23 and risk of incident subarachnoid hemorrhage (SAH) in a nested case-control study. METHODS: FGF23 was analyzed in stored blood samples from incident SAH cases (n=79) and control subjects (n=232), participating in the prospective, population-based Malmö Diet and Cancer Study. The association between FGF23 and SAH was studied using conditional logistic regression. RESULTS: High FGF23 was associated with incident SAH. In the highest compared with the lowest quartile of FGF23, the odds ratio for SAH was 3.28 (95% confidence interval, 1.34-8.00), P for trend=0.006, after adjustment for SAH risk factors. CONCLUSIONS: High FGF23 was associated with increased risk of incident SAH in subjects from the general population. Further studies should elucidate whether FGF23 is a causal risk factor for SAH, or could be used in risk prediction.