Pollution as a risk factor for stroke

Air pollution (from fine particulate matter, ozone, nitrogen dioxide and sulphur dioxide) has been identified as a significant risk factor for stroke. Air pollution contributed to 700,000 deaths from stroke globally1. Research suggests that exposure to air pollution can increase the risk of both ischaemic stroke (caused by a blockage to the blood supply in the brain) and haemorrhagic strokes (caused by a brain bleed).

Long-term exposure to polluted air has been linked to the thickening and hardening of the walls of arteries (atherosclerosis), high blood pressure, and irregular heart rhythms, all of which are risk factors for stroke2.

A recent report from the Global Burden of Disease Study suggests that “Ambient particulate matter pollution accounted for 16.7% stroke risk and household air pollution accounted for 11.3% of stroke risk.” In addition, the research suggests that there are large disparities between low-, middle- and high-income countries in stroke risk from pollution3.

Older people, those with pre-existing cardiovascular conditions and people living in busy urban areas with high pollution levels may have a higher risk of stroke. Socioeconomic factors (for example income levels) also play a role, with minority communities often bearing the brunt of environmental pollution4.

Pollution and stroke risk: Key points

The main way to tackle the increased risk of stroke caused by pollution is to make changes at community and national levels:

  • National regulation on vehicle emissions
  • National regulation on industrial emissions
  • Traffic restrictions in urban areas (for example, low emission zones)
  • Incentives to use public transport and cycling instead of cars
  • Better planning to ensure that schools and housing are not located near busy roads or motorways
  • Supporting renewable energy sources, promoting green transportation and investing in sustainable practices

On an individual level, you can monitor air pollution indices (such as ozone or particulate), wear masks and avoid outdoor physical activity on higher pollution days if possible.

 
 

References

  1. World Heart Federation. Clearing the air to address pollution’s cardiovascular health crisis. 2024. https://world-heart-federation.org/report2024/
  2. Erin R Kulick, Joel D Kaufman  Coralynn Sack. Ambient Air Pollution and Stroke: An Updated Review. Stroke. 2023. Mar;54(3):882-893. https://doi.org/10.1161/STROKEAHA.122.035498
  3. Jaimie D Steinmetz et al. Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurology. 2024. Apr;23(4):344-381. https://doi.org/10.1016/S1474-4422(24)00038-3
  4. A Avan, H Digaleh, M Di Napoli et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017. BMC Med. 2019.17(191). https://doi.org/10.1186/s12916-019-1397-3

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