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

Oudin, Anna; Stromberg, Ulf; Jakobsson, Kristina; Stroh, Emilie; Lindgren, Arne LU ; Norrving, Bo LU ; Pessah-Rasmussen, Hélène LU ; Engström, Gunnar LU and Björk, Jonas LU (2011) In Cerebrovascular Diseases 31(3). p.284-293
Abstract
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... (More)
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 (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ischemic stroke, Air pollution, Diabetes mellitus, Long-term exposure, Effect modification
in
Cerebrovascular Diseases
volume
31
issue
3
pages
284 - 293
publisher
Karger
external identifiers
  • wos:000291816300011
  • scopus:78650638012
ISSN
1421-9786
DOI
10.1159/000322600
language
English
LU publication?
yes
id
cebbb8ba-b616-417f-803e-3e0e8de20d15 (old id 2056764)
date added to LUP
2011-08-02 09:02:19
date last changed
2017-03-12 03:20:12
@article{cebbb8ba-b616-417f-803e-3e0e8de20d15,
  abstract     = {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},
  author       = {Oudin, Anna and Stromberg, Ulf and Jakobsson, Kristina and Stroh, Emilie and Lindgren, Arne and Norrving, Bo and Pessah-Rasmussen, Hélène and Engström, Gunnar and Björk, Jonas},
  issn         = {1421-9786},
  keyword      = {Ischemic stroke,Air pollution,Diabetes mellitus,Long-term exposure,Effect modification},
  language     = {eng},
  number       = {3},
  pages        = {284--293},
  publisher    = {Karger},
  series       = {Cerebrovascular Diseases},
  title        = {Hospital Admissions for Ischemic Stroke: Does Long-Term Exposure to Air Pollution Interact with Major Risk Factors?},
  url          = {http://dx.doi.org/10.1159/000322600},
  volume       = {31},
  year         = {2011},
}