Hospital admissions for ischemic stroke: does long-term exposure to air pollution interact with major risk factors?
2011 (English)In: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 31, no 3, 284-293 p.Article in journal (Refereed) Published
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 Malmö and Lund Stroke Registers. Population controls were matched on age and sex. Modeled outdoor annual mean NO(x) concentrations were used as proxy for long-term exposure to air pollution. Heterogeneity across NO(x) 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 NO(x) 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 NO(x) (p for trend = 0.033). We observed no main effect of mean NO(x) or any conclusive effect modifications between NO(x) 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.
Place, publisher, year, edition, pages
S. Karger, 2011. Vol. 31, no 3, 284-293 p.
Ischemic stroke, Air pollution, Diabetes mellitus, Long-term exposure, Effect modification
Cardiac and Cardiovascular Systems Neurology
IdentifiersURN: urn:nbn:se:umu:diva-39333DOI: 10.1159/000322600ISI: 000291816300011PubMedID: 21196728OAI: oai:DiVA.org:umu-39333DiVA: diva2:390790