Environment and stroke

Abstract

Stroke causes more than 6 million deaths each year and leaves behind an even greater number with significant disability. Amongst some of the recent discoveries, is the influence of environment on cardiovascular health. One aspect of this, which is environmental pollution is considered the third largest contributor to Disability Adjusted Life Years (DALYs) due to stroke. According to the Global burden of disease study, 2013, air pollution accounted for almost 30% of global stroke burden, with low and middle-income countries (LMICs) being more severely affected. In South Asia and sub-Saharan Africa, 40% of Disability Adjusted Life Years (DALYs) due to stroke, were attributable to air pollution. Another alarming finding from the study was the contribution of household air pollution (HAP) from incomplete combustion of fossil fuel in the LMICs. Both short term and long term exposure to particulate air pollution has been recognized as independent risk factor for myocardial disease, stroke and heart failure. Considering the attributable fraction of environmental pollution on cardiovascular health including stroke, it is only wise to focus attention on a risk factor that is so ubiquitous that any intervention at that level is likely to produce huge impacts. There is a need to first, measure environmental pollution accurately and then to implement the existent policies besides drafting new ones to reduce vehicles on the roads, improve the quality of fuel, curb industrial pollution and to improve garbage disposal. The role of urban green spaces is also being recognized in enhancing physical activity and reducing cardiovascular disease risk and all future urban planning should incorporate these. Future health research needs to focus on better categorizing the risks that various environmental factors pose to inform better policies.