Ambient Air Pollution and Stroke Petter L. Ljungman and Murray A. Mittleman Stroke. published online October 9, 2014; Stroke is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231 Copyright © 2014 American Heart Association, Inc. All rights reserved. Print ISSN: 0039-2499. Online ISSN: 1524-4628

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Topical Review Section Editors: Armin J. Grau, MD, PhD, and George Howard, DrPH

Ambient Air Pollution and Stroke Petter L. Ljungman, MD, PhD; Murray A. Mittleman, MD, DrPH

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troke is a leading cause of death in the United States1 and worldwide (http://www.who.int) and may lead to considerable neurological sequelae including aphasia, paraplegia, and dementia. The estimated healthcare costs of stroke in the United States exceed $36 billion per year.1 A large body of evidence supports the association between ambient air pollution exposure and increased cardiovascular mortality and morbidity,2 but only recently have several studies specifically demonstrated an association with increased stroke risk.

Background Major sources of air pollution include traffic, power plants and in developing countries, biomass combustion. Both particles and gases are emitted through combustion. Particulate matter with aerodynamic diameter 60 years old, never-smokers, and among subjects with exposure levels

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