The burden of stroke attributable to ambient particulate matter pollution in China: findings from the Global Burden of Disease Study 2021

Stroke remains a major contributor to mortality and disability in China, with ambient particulate matter (PM) pollution identified as a critical modifiable risk factor. Leveraging data from the Global Burden of Disease 2021 study, this research quantifies the burden of stroke attributable to ambient PM pollution in China from 1990 to 2021. Analyses included age-standardized prevalence, mortality, disability-adjusted life years (DALYs), and comparisons with global, Asian, and US trends. We found that the burden of ischemic stroke increased, while that of intracerebral hemorrhage and subarachnoid hemorrhage decreased. China exhibited higher age-standardized mortality and DALY rates for the stroke burden attributable to ambient PM pollution compared to the global average, Asia, and the USA, with rates peaking around 2010-2015. Males carried a heavier burden of stroke caused by ambient PM pollution across all stroke subtypes, and older age groups in China faced much higher risks, with rates in this group surpassing those in other regions. These trends underscore the escalating public health challenge posed by PM pollution in China, especially among aging populations, and highlight the urgent need for targeted air quality interventions and age-specific preventive strategies to mitigate stroke burden.