Air pollution is a leading global risk factor for stroke, according to a study published in Lancet Neurology.

Valery L Feigin, MD, National Institute for Stroke and Applied Neurosciences, faculty of Health and Environmental Studies, Auckland University of Technology, New Zealand, and colleagues, conducted an analysis of data on global trends and risk factors for stroke gathered between 1990 and 2013. The researchers estimated the burden of stroke by both age and sex, and evaluated the disability-adjusted life-years (DALYs) for 17 risk factors.

Results indicate that greater than 90% of the global burden of stroke is linked to modifiable risk factors, 74% of which are behavioral risk factors including smoking, poor diet, and low physical activity. About one-third (29.2%) of global disability associated with stroke is linked to both environmental and household air pollution, especially in developing countries (33.7% versus 10.2% in developed countries). Specifically, household air pollution was a more important stroke risk factor in Central, Eastern, and Western sub-Saharan Africa and South Asia, compared to North America and Central, Eastern, and Western Europe.

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“A striking finding in our study is the unexpectedly high proportion of stroke burden attributable to environmental air pollution, especially in developing countries,” noted Dr Feigin. “Smoking, poor diet, and low physical activity are some of the major risk factors for stroke … suggesting that stroke is largely a disease caused by lifestyle risk factors. Controlling these risk factors could prevent about three-quarters of strokes worldwide.

“Our findings are important for helping national governments and international agencies to develop and prioritize public health programs and policies,” Dr Feigin concluded. “Governments have the power and responsibility to influence these risk factors.”


  1. Feigin VL, Roth GA, Naghavi M, et al. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol. 2016; doi: 10.1016/S1474-4422(16)30073-4