Hospital Admissions for Ischemic Stroke: Does Long-Term Exposure to Air Pollution Interact with Major Risk Factors?

Summary, in English

Background: The aim was to investigate whether the effects of major risk factors for ischemic stroke were modified by long-term exposure to air pollution in Scania, southern Sweden. Methods: Cases were defined as first-ever ischemic strokes in patients born between 1923 and 1965 during 2001-2006 (n = 7,244). Data were collected from The Swedish National Stroke Register (Riks-stroke) and the Malmo and Lund Stroke Registers. Population controls were matched on age and sex. Modeled outdoor annual mean NOx concentrations were used as proxy for long-term exposure to air pollution. Heterogeneity across NOx categories was tested for smoking, hypertension, diabetes mellitus, atrial fibrillation and physical inactivity. Data were analyzed as case-control data and to some extent as case-only data, with logistic regression analysis. Results: The case-control odds ratios for ischemic stroke in association with diabetes were 1.3 [95% confidence interval (CI): 1.1-1.6] and 2.0 (95% CI: 1.2-3.4) in the lowest and highest NOx category, respectively (p value for testing heterogeneity across the categories = 0.056). The case-only approach gave further support for the risk associated with diabetes to increase with NOx (p for trend = 0.033). We observed no main effect of mean NOx or any conclusive effect modifications between NOx and smoking, hypertension, atrial fibrillation or physical inactivity. Conclusions: In a low-level air pollution area, the risk for ischemic stroke associated with diabetes seemed to increase with long-term exposure to air pollution. Copyright (C) 2010 S. Karger AG, Basel

• Författare: Anna Oudin; Ulf Stromberg; Kristina Jakobsson; Emilie Stroh; Arne Lindgren; Bo Norrving; Hélène Pessah-Rasmussen; Gunnar Engström; Jonas Björk
• Avdelning/ar: Neurologi, Lund; Sektion IV; Kardiovaskulär forskning - epidemiologi; Avdelningen för arbets- och miljömedicin; EpiHealth: Epidemiology for Health
• Publiceringsår: 2011
• Språk: Engelska
• Sidor: 284-293
• Publikation/Tidskrift/Serie: Cerebrovascular Diseases
• Volym: 31
• Issue: 3
• Länkar: http://dx.doi.org/10.1159/000322600
• Dokumenttyp: Artikel i tidskrift
• Förlag: Karger
• Ämne: Cardiac and Cardiovascular Systems
• Nyckelord: Ischemic stroke; Air pollution; Diabetes mellitus; Long-term exposure; Effect modification
• Status: Published
• Forskningsgrupp: Cardiovascular Research - Epidemiology
• ISBN/ISSN/Övrigt: ISSN: 1421-9786