Cerebral cavernous malformations (CCMs) are neurological disorders that make individuals more susceptible to hemorrhagic stroke. The Mexican-Hispanic population has a higher prevalence of both CCMs and metabolic syndrome (MetS), which is also associated with hemorrhagic stroke. A study was conducted with 184 Mexican-Hispanic CCM subjects and age- and sex-matched Hispanic and non-Hispanic white controls. The CCM cohort had a higher proportion of epilepsy and hemorrhagic stroke but a lower proportion of MetS. Higher blood pressure and fasting glucose levels were observed in the CCM cohort. MetS and epilepsy were associated with increased odds of hemorrhagic stroke among elderly CCM patients, and increased systolic blood pressure was significantly linked to increased odds of hemorrhagic stroke in the CCM cohort. To minimize the risk of hemorrhagic stroke, it is important to manage blood pressure and comorbidities like MetS and epilepsy in CCM patients, particularly those older than 50.SUMMARUYWhat is already known about this subjectMetabolic Syndrome (MetS) is widely associated with cardiovascular conditions, including stroke,The association between MetS and ischemic stroke is well establishedThe relationship between MetS and hemorrhagic stroke remains unclearCurrently, one two studies explored the relationship between MetS and hemorrhagic stroke in CCM patients; one n sporadic CCM (sCCM) and one in familial CCM cases, with inconsistent results.What are the new findingsIn this study, a strong association was observed between systolic blood pressure (SBP) and hemorrhagic stroke in the CCM cohort, independent of obesity or fasting glucose levels.This study also suggests that MetS is associated with hemorrhagic stroke among CCM patients, specifically in the older age group.How might it impact on clinical practice in the foreseeable futureThis study demonstrates many of the unique characteristics of symptomatic CCMs within the Mexican-Hispanic populationOur results suggests that of Mexican-Hispanic CCM subjects are at a greater risk for hemorrhagic stroke and epilepsy than other ethnic groups.This study highlights the importance of reducing blood pressure and managing comorbidities such as MetS and epilepsy in CCM patients, especially those who are older than 50 years to minimize the risk of hemorrhagic stroke among CCM subjects