Lu Yunyan, Mao Yu, Liu Weiguo, Lan Tian, Lan Gaochen
Department of Cardiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China.
Department of Oncology, The People's Hospital of Jiangshan, Quzhou, Zhejiang, China.
Front Public Health. 2025 Jul 16;13:1608086. doi: 10.3389/fpubh.2025.1608086. eCollection 2025.
To evaluate the spatiotemporal variation in ischemic stroke attributed to particulate matter 2.5 (PM2.5) on global, regional, and national scales from 1990 to 2021 is essential for mitigating air pollution and controlling ischemic stroke.
The death and disability-adjusted life years (DALYs) were extracted from the Global Burden and Disease Study (GBD) 2021. We utilized joinpoint regression and decomposition analysis to assess PM2.5 exposure and pinpoint high-risk areas.
In 2021, PM2.5 caused approximately 0.90 million mortality and 18.29 million DALYs due to ischemic stroke worldwide. The age-standardized rates (ASRs) of ischemic stroke linked to ambient PM2.5 slightly declined, while those associated with household PM2.5 significantly decreased over the past 32 years. The burden of ischemic stroke attributable to ambient and household PM2.5 exhibited considerable heterogeneity across 204 countries. Household PM2.5 significantly affected ischemic stroke burdens in low Socio-demographic indices (SDI) regions, whereas ambient PM2.5 had a greater impact in middle, high-middle, and high SDI regions. In the regions with an SDI below 0.7, including Southern Sub-Saharan Africa and East, South, and Southeast Asia, there was a positive correlation between SDI and ASRs linked with ambient PM2.5. Notably, in the 65-95 age group, the age-specific rates associated with ambient PM2.5 showed a substantial decline among females, while the rates for males remained relatively stable.
Our results presented that PM2.5 significantly affects global ischemic stroke burden, particularly among the male population and in low SDI regions. It highlighted the urgency of integrating PM2.5 reduction strategies with ischemic stroke prevention programs.
评估1990年至2021年全球、区域和国家尺度上，归因于细颗粒物2.5（PM2.5）的缺血性卒中的时空变化，对于减轻空气污染和控制缺血性卒中至关重要。
从《2021年全球疾病负担研究》（GBD）中提取死亡和伤残调整生命年（DALYs）。我们利用连接点回归和分解分析来评估PM2.5暴露情况并确定高风险区域。
2021年，PM2.5在全球范围内导致约90万人因缺血性卒中死亡，以及1829万伤残调整生命年。在过去32年中，与环境PM2.5相关的缺血性卒中年龄标准化率（ASRs）略有下降，而与家庭PM2.5相关的年龄标准化率则显著下降。在204个国家中，归因于环境和家庭PM2.5的缺血性卒中负担存在相当大的异质性。家庭PM2.5对社会人口指数（SDI）较低地区的缺血性卒中负担有显著影响，而环境PM2.5在中等、中高和高SDI地区影响更大。在SDI低于0.7的地区，包括撒哈拉以南非洲南部以及东亚、南亚和东南亚，SDI与环境PM2.5相关的ASRs之间存在正相关。值得注意的是，在65 - 95岁年龄组中，与环境PM2.5相关的年龄别发病率在女性中大幅下降，而男性的发病率则相对稳定。
我们的结果表明，PM2.5显著影响全球缺血性卒中负担，尤其是在男性人群和低SDI地区。这凸显了将降低PM2.5策略与缺血性卒中预防计划相结合的紧迫性。
