Ambient Air Pollution and Stroke

Ljungman, Petter; Mittleman, Murray A.

doi:10.1161/strokeaha.114.003130

Cited by 95 publications

(61 citation statements)

References 74 publications

(92 reference statements)

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“…4, 5, 12 Several prior studies have reported associations between long-term pollution exposure and living close to major roads with incident stroke 1, 31, 32 and poorer cognitive function in older adults. 2, 3, 33 Living in a high air pollution region in Mexico City was associated with greater accumulation of β-amyloid-42 in the frontal cortex and hippocampus than living in a non-polluted area.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Exposure to Fine Particulate Matter, Residential Proximity to Major Roads and Measures of Brain Structure

Wilker

Preis

Beiser

et al. 2015

Stroke

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226

159

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Background and Purpose Long-term exposure to ambient air pollution is associated with cerebrovascular disease and cognitive impairment, but whether it is related to structural changes in the brain is not clear. We examined the associations between residential long-term exposure to ambient air pollution and markers of brain aging using magnetic resonance imaging (MRI). Methods Framingham Offspring Study participants who attended the seventh examination, were at least 60 years old and free of dementia and stroke were included. We evaluated associations between exposures (fine particulate matter (PM2.5) and residential proximity to major roadways) and measures of total cerebral brain volume, hippocampal volume, white matter hyperintensity volume (log-transformed and extensive white matter hyperintensity volume for age) and covert brain infarcts. Models were adjusted for age, clinical covariates, indicators of socioeconomic position, and temporal trends. Results A 2 μg/m3 increase in PM2.5 was associated with -0.32% (95%CI: -0.59, -0.05) smaller total cerebral brain volume and 1.46 (95%CI: 1.10, 1.94) higher odds of covert brain infarcts. Living further away from a major roadway was associated with 0.10 (95%CI: 0.01, 0.19) greater log-transformed white matter hyperintensity volume for an interquartile range difference in distance, but no clear pattern of association was observed for extensive white matter. Conclusions Exposure to elevated levels of PM2.5 was associated with smaller total cerebral brain volume, a marker of age-associated brain atrophy, and with higher odds of covert brain infarcts. These findings suggest that air pollution is associated with insidious effects on structural brain aging even in dementia-and stroke-free persons.

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Section: Discussionmentioning

confidence: 99%

“…Long-term exposure to particulate air pollution has been associated with higher incidence of stroke 1 and impaired cognitive function in older adults. 2, 3 Long-term exposures have also been associated with changes in cerebral hemodynamics, 4 impaired microvascular reactivity 5 and greater carotid atherosclerotic burden.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Exposure to Fine Particulate Matter, Residential Proximity to Major Roads and Measures of Brain Structure

Wilker

Preis

Beiser

et al. 2015

Stroke

Self Cite

226

159

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“…Case-crossover studies in Massachusetts (Wellenius et al, 2012), Pennsylvania (Xu et al, 2013), and France (Henrotin et al, 2010) reported no associations between same day or previous day O 3 with risk of ischemic stroke; these studies also reported lower average daily concentrations of O 3 than we observed. Additionally, recent reviews and meta-analyses have suggested null to small associations between O 3 and ischemic stroke, with slightly stronger effects in case-crossover studies (Ljungman and Mittleman, 2014; Shah et al, 2015). Conversely to our results, some studies have found an association between PM 2.5 and incident stroke.…”

Section: Discussionmentioning

confidence: 99%

Ethnic differences in ambient air pollution and risk of acute ischemic stroke

Wing

Adar

Sánchez

et al. 2015

Environmental Research

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Objectives To investigate the association between short-term changes in ambient pollution (particulate matter < 2.5μm in aerodynamic diameter (PM2.5) and ozone (O3)) and the risk of ischemic stroke among individuals living in a bi-ethnic community and whether this association is modified by ethnicity. Methods We identified incident ischemic stroke cases from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) project between 2000 and 2012. Associations between PM2.5 (mean 24-hour) and O3 (maximal 8-hour) levels, measured on the same-day and lags of 1-3 days, and odds of ischemic stroke were assessed using a time-stratified case-crossover design and modeled using conditional logistic regression. We explored race/ethnicity (Mexican American versus non-Hispanic white) as a modifier by including interaction terms in the models. Results There were 2,948 ischemic strokes with median age 71 years (IQR: 59-80). We observed no overall associations between the air pollutants and odds of ischemic stroke at any lag. When stratified by ethnicity, higher O3 was consistently associated with greater odds of ischemic stroke for non-Hispanic whites, but not for Mexican Americans. Higher PM2.5 was generally associated with lower odds of ischemic stroke for non-Hispanic whites but modestly greater odds for Mexican Americans. Conclusion Ethnic differences in the associations between ischemic stroke and short-term exposures to O3 and PM2.5 were suggested indicating that further study in diverse populations may be warranted.

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“…Oxidative stress, an imbalance between the production of the reactive oxygen species and the human body's antioxidant defense mechanism,4 has been proposed as an important underlying biological mechanism mediating this association 3, 5, 6, 7. Increased oxidative stress may induce endothelial dysfunction, which is characterized by increased endothelial permeability, altered vascular tone, platelet adhesion and aggregation, and enhanced thrombogenicity 8, 9…”

Section: Introductionmentioning

confidence: 99%

Short‐Term Exposure to Air Pollution and Biomarkers of Oxidative Stress: The Framingham Heart Study

Wilker

Dorans

et al. 2016

JAHA

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122

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BackgroundShort‐term exposure to elevated air pollution has been associated with higher risk of acute cardiovascular diseases, with systemic oxidative stress induced by air pollution hypothesized as an important underlying mechanism. However, few community‐based studies have assessed this association.Methods and ResultsTwo thousand thirty‐five Framingham Offspring Cohort participants living within 50 km of the Harvard Boston Supersite who were not current smokers were included. We assessed circulating biomarkers of oxidative stress including blood myeloperoxidase at the seventh examination (1998–2001) and urinary creatinine‐indexed 8‐epi‐prostaglandin F2α (8‐epi‐PGF 2α) at the seventh and eighth (2005–2008) examinations. We measured fine particulate matter (PM 2.5), black carbon, sulfate, nitrogen oxides, and ozone at the Supersite and calculated 1‐, 2‐, 3‐, 5‐, and 7‐day moving averages of each pollutant. Measured myeloperoxidase and 8‐epi‐PGF 2α were loge transformed. We used linear regression models and linear mixed‐effects models with random intercepts for myeloperoxidase and indexed 8‐epi‐PGF 2α, respectively. Models were adjusted for demographic variables, individual‐ and area‐level measures of socioeconomic position, clinical and lifestyle factors, weather, and temporal trend. We found positive associations of PM 2.5 and black carbon with myeloperoxidase across multiple moving averages. Additionally, 2‐ to 7‐day moving averages of PM 2.5 and sulfate were consistently positively associated with 8‐epi‐PGF 2α. Stronger positive associations of black carbon and sulfate with myeloperoxidase were observed among participants with diabetes than in those without.ConclusionsOur community‐based investigation supports an association of select markers of ambient air pollution with circulating biomarkers of oxidative stress.

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Ambient Air Pollution and Stroke

Cited by 95 publications

References 74 publications

Long-Term Exposure to Fine Particulate Matter, Residential Proximity to Major Roads and Measures of Brain Structure

Long-Term Exposure to Fine Particulate Matter, Residential Proximity to Major Roads and Measures of Brain Structure

Ethnic differences in ambient air pollution and risk of acute ischemic stroke

Short‐Term Exposure to Air Pollution and Biomarkers of Oxidative Stress: The Framingham Heart Study

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