Evidence mapPaperPMID 41587749Full record

ArticleEuropean heart journal2026

Long-term exposure to wildfire smoke particulate matter and incident stroke: a US nationwide study.

Hua Hao, Ke Xu, Danlu Zhang, Yanling Deng, Tarik Benmarhnia, Qiang Pu, Varun K Pattisapu, Kyle Steenland, Howard H Chang, Alvaro Alonso and 1 more

Abstract read
In one paragraph

Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hua HaoGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.ORCID 0000-0001-5431-7984
Ke XuGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
Danlu ZhangGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
Yanling DengGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
Tarik BenmarhniaScripps Institution of Oceanography Department, University of California San Diego, La Jolla, CA, USA.
Qiang PuCollege for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA.
Varun K PattisapuDepartment of Cardiology, Piedmont Heart Institute, Piedmont Hospital, Atlanta, GA, USA.
Kyle SteenlandGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
Howard H ChangDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Alvaro AlonsoDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.ORCID 0000-0002-2225-8323
Yang LiuGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.ORCID 0000-0001-5477-2186

Funding

The impact of wildfire smoke exposure on cardiovascular health in the western USR01ES034175 · EMORY UNIVERSITY · 2025 to 2025
$504k
NIH HHS R01ES034175
6 · The paper itself

Abstract

BACKGROUND AND

aimsWildfire smoke is a growing public health concern, particularly due to its high fine particulate matter (PM2.5) concentrations. While short-term exposure has been linked to adverse cardiovascular outcomes, long-term effects remain understudied. This study examined the association between long-term wildfire smoke PM2.5 exposure and incident stroke among older US adults.

methodsA national open cohort study was conducted among Medicare Fee-for-Service beneficiaries aged ≥65 years from 2007 to 2018. Stroke cases were identified using validated Medicare claims. Wildfire smoke PM2.5 exposure was estimated at a 1 km2 resolution using a machine learning model distinguishing smoke-specific PM2.5 from other ambient sources. Stratified Cox proportional hazards models with generalized estimating equations were used to estimate hazard ratios (HRs) per 1 µg/m3 increase in wildfire smoke PM2.5, adjusting for non-smoke PM2.5, meteorological variables, socio-economic status, and healthcare capacity.

resultsAmong ∼25 million beneficiaries, ∼2.9 million incident stroke cases occurred. Long-term wildfire smoke PM2.5 exposure was significantly associated with increased stroke risk. Stronger associations were observed for longer exposure windows. For instance, per 1 µg/m3 increase in 3-year average wildfire smoke PM2.5 was associated with a 1.3% increase in stroke risk (HR: 1.013; 95% CI: 1.006, 1.020). Associations for wildfire smoke PM2.5 were generally stronger than for non-smoke PM2.5 per unit exposure.

conclusionsThis study provides national-scale evidence that chronic exposure to wildfire smoke PM2.5 increases stroke risk in older adults. These findings underscore the long-term health risks of wildfire smoke and support policies aimed at reducing exposure, especially among vulnerable populations.

Indexed as

Environmental ExposureParticulate MatterSmokeStrokeWildfiresAgedAged, 80 and overFemaleHumansIncidenceMaleMedicareUnited StatesParticulate MatterSmokeElderlyFine particulate matterLong-term exposureStrokeWildfire

Identifiers

PMID41587749
PMCPMC13225884

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.