Dr Saket Patil, Consultant Neurologist, HCG Suchirayu Hospital, Hubballi
The daily commute to the workplace, the walk through a bustling community or moving through a construction site have become a common part of city life. These small everyday acts brings exposure to something that we tend to take for granted the air around us. While air pollution is routinely discussed in context of respiratory health its adverse effect extends to the cardiovascular system and ultimately impacting the brain too.
Hypertension, diabetes, cholesterol and lifestyle habits are common associated stroke prevention concerns. However the environment is another emerging matter of concern for stroke prevention. The link between air pollution and vascular health prompts an interesting query regarding whether the air breathed into the lungs is also affecting the vessels responsible for nourishing the brain.
The Invisible Pollution That Travels Further Than Expected
However, not all forms of pollution are observable. Fine particulates, especially PM2.5, have become increasingly common pollutants whose harmful effects to the body are receiving medical attention. They get into the air through exhausts, factories, constructions, and waste burning.
The impacts of these toxins might not be limited to just the respiratory tract. Contact with such compounds may cause inflammation and oxidative stress, which may have an impact on how the blood vessels function. The endothelium is the lining of the blood vessels that helps in regulating blood flow.
This is where the discussion of the environment starts to relate to brain health. The brain needs a steady flow of oxygen-filled blood, which means that the condition of the blood vessels feeding the brain becomes vital.
When the Air Becomes a Silent Vascular Stressor
Linkages between stroke and air pollution are based on a number of mechanisms occurring in the cardiovascular system.
The inflammation mechanism: The exposure to pollution can lead to the inflammation processes and oxidative stress, which could have an impact on the vessel elasticity and functioning.
The blood pressure mechanism: Air pollution is known to be linked to the changes in blood pressure and vascular functions. This is yet another issue for those patients who suffer from hypertension.
The clotting mechanism: Some pollutants in the air could affect platelet functioning and the process of blood coagulation. This could create a situation favourable for the formation of clots, thus, for an ischemic stroke.
These mechanisms prove that air pollution is a topic worth discussing not only because of the problems with coughing, allergy and breathing.
The Urban Lifestyle Has an Environmental Blind Spot
To most city dwellers, environmental exposure is a feature of their daily lives. Traffic jams, dust on the roads, construction sites, and factories can make it hard to escape environmental exposure.
Indoors too can be sources of pollution, through cooking smoke, cigarette smoke, poor ventilation and the use of solid fuels.
The issue becomes especially important for elderly people and those suffering from cardiovascular diseases, high blood pressure, diabetes, and high cholesterol levels. Yet environmental exposure is not an issue for those who already have health problems only. Air quality should be considered a factor of preventative health care.
Can Cleaner Air Become Part of Stroke Prevention?
While zero pollution might not be achievable, increased awareness will definitely help limit unwanted exposure to the pollutant. Some of the things that can be considered in this case include checking the levels of Air Quality Index in your local area, taking routes which have low traffic congestion when you want to venture outdoors and avoiding exercises when the air is bad.
Wearing N95 respirators which fit properly is another way in which the fine particulates from the outdoor pollution can be avoided. Other than all this, normal preventative steps such as maintaining healthy blood pressure, controlling diabetes, managing healthy cholesterol levels and avoiding smoking are still necessary.
Rethinking What It Means to Protect Brain Health
Discussions regarding the prevention of strokes continue to broaden beyond the limits of clinical risk factors. Exposure to the environment opens a new perspective in regard to the issue of vascular health in the context of the connection between personal well-being and the environment.
For health professionals, the identification of air pollution as one of the possible risk factors will open the way for discussions. In regard to urban populations, this will serve as further confirmation of the fact that clean air should be considered a matter of public health and not only an environmental one.
This is because brain health does not depend on food and medicines only but also on the quality of air inhaled through breathing.
