ArticleJournal of the American Heart Association2026
Association Between Living Environmental Factors and Stroke in Middle-Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Factors Associated with e-Health Literacy Among Older Adults in Klang Valley, Malaysia: A Cross-Sectional Survey.Healthcare (Basel, Switzerland) · 2026Article
- Adjuvant therapy with total salvianolic acid injection enhances the safety and efficacy of recombinant prourokinase in ischemic stroke by mitigating blood-brain barrier disruption.Journal of translational medicine · 2026Article
- Uric Acid and Uric Acid Index in Predicting Coronary Artery Disease, Cerebrovascular Events, and Mortality: A Sex-Stratified Cohort Study.Clinical cardiology · 2026Article
- Joint association of lung function and physical activity with risk of incident stroke among the US and Chinese adults.BMC public health · 2026Article
- A multi-parameter predictive model incorporating VEGF for asymptomatic cerebral infarction after RFCA in atrial fibrillation.Frontiers in cardiovascular medicine · 2026Article
- Age Modifies the Association Between Smoking and Carotid Artery Plaque: A Cross-Sectional Study in Non-Diabetic Adults.International journal of general medicine · 2026Article
- CTI-related composite adiposity indices and future cardiovascular disease risk among middle-aged and older Chinese adults.Frontiers in nutrition · 2026Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe synergistic effects of multiple environmental factors on stroke remain unknown. The aim of this study was to explore the relationship between multiple living environment factors and stroke in middle-aged and older Chinese adults.
methodsThis study used data of the CHARLS (China Health and Retirement Longitudinal Study). Living environmental factors included ambient fine particulate matter, indoor fuel use, tap water use, room temperature, and residence type. Stroke was ascertained by self-reported physician-diagnosed stroke. Cox proportional hazard regression models were applied to explore the association between living environmental risk factors and stroke events in a cohort analysis. Multiple sensitivity analyses were used to test the robustness of the present finding.
resultsA total of 6483 participants from CHARLS (mean age: 58.17 years; female: 54.17%) were included in the 7-year follow-up. Individuals in the middle-risk (adjusted hazard ratio [HR], 0.73 [95% CI, 0.58-0.90]) and low-risk groups (adjusted HR, 0.56 [95% CI, 0.39-0.80]) demonstrated a 27% and 44% reduction in stroke risk, respectively, compared with the high-risk reference group, when evaluating the synergistic effects of residential environmental exposures. In the fully adjusted continuous model, each 1-unit increment in living environmental quality scores was associated with a 15% lower risk of stroke incidence (adjusted HR, 0.85 [95% CI, 0.78-0.91]). The results of the sensitivity analysis confirmed that our findings are robust.
conclusionsLiving environmental quality is significantly associated with stroke. Poor living quality may increase the risk of stroke. Future studies should focus more on the synergistic effects of exposure to living environmental factors.
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