Najla Ajaj

Background: Environmental surroundings reduce the rate of several diseases, especially those related to stressful events. Ischemic stroke can be affected by such events, either directly or through its risk factors. Therefore, the present study evaluates the effects of green spaces and noise exposure on the risk of ischemic stroke. Methods: A case–control study was carried out, including 200 ischemic stroke cases within the first 48 h of diagnosis and 200 controls, divided equally into hospitalized and non-hospitalized participants. Controls were matched to cases based on age and gender. Socio-demographic characteristics were assessed, in addition to environmental surroundings and noise exposure at home and at workplaces. Results: Living in a house, having a house garden, and taking care of the garden were associated with a lower risk of suffering an ischemic stroke (p < 0.001, p < 0.001, and p = 0.009, respectively). However, having buildings as the view from home led to a higher stroke rate (p < 0.001). Working in an urban area, the workplace being surrounded by buildings, and the workplace not being surrounded by green spaces were also associated with a higher risk of suffering an ischemic stroke (p = 0.002, p = 0.001, and p = 0.03, respectively). As for noise exposure, being exposed to traffic noise, human noise, and other types of noise was significantly associated with a higher risk of ischemic stroke, while being exposed to higher levels of natural noise was significantly associated with a lower risk of ischemic stroke. Higher levels of noise were also associated with higher risks of ischemic stroke in homes and workplaces (p < 0.001 and p = 0.008, respectively). Conclusions: Environmental surroundings and noise exposure were found to affect the risk of ischemic stroke. Greater green spaces and lower noise exposure play a protective role against ischemic stroke, suggesting a possible prevention strategy through environmental modifications at home and workplaces.

Background: Hypertension is a major risk factor for ischemic stroke. An important strategy in controlling hypertension is dietary modification. The present study evaluates the effect of Dietary Approaches to Stop Hypertension (DASH) diet on the risk of ischemic stroke. Methods: A case–control study was carried out, including 214 ischemic stroke cases recruited within the first 48 h of diagnosis and 214 controls, divided equally into hospitalized and non-hospitalized participants. Controls were matched to cases based on age and gender. Socio-demographic characteristics were assessed, in addition to adherence to the DASH diet, which was measured using a preconstructed DASH diet index (ranging from 0 (lowest) to 11 (highest)). For stroke patients, Modified Rankin Score (mRS) was measured to assess disability. Results: Smoking, hypertension, hyperlipidemia, atrial fibrillation, and myocardial infarction were significantly associated with ischemic stroke (p < 0.001). Higher adherence to the DASH diet was correlated to lower rates of stroke, where cases scored 5.042 ± 1.486 compared to 6.654 ± 1.471 for controls (p < 0.001). Eating more grains, vegetables, fruits, dairy products, nuts, seeds, and beans, and lower levels of fat, fewer sweets, and less sodium were associated with lower rates of ischemic stroke (p = 0.038 for sweets and p < 0.001 for all the remaining), while meat, poultry, and fish did not have any significant effect (p = 0.46). A multivariate analysis showed that lower adherence to the DASH diet (p < 0.001, OR: 0.526, CI95% 0.428–0.645) was associated with a higher incidence of ischemic stroke and an increased likelihood of having high disability levels (mRS 5–6) (p = 0.041, OR: 2.49 × 10⁻⁸, CI95% 0–2.49 × 10⁻⁸). Conclusions: The relation between the DASH diet and risk of stroke highlights the necessity for strict adherence to dietary restrictions, suggesting a protective role for the DASH diet in stroke pathogenesis and prognosis.