Abstract P631: The Relationship of Neighborhood Greenness to Stroke/ Transient Ischemic Attack in 249,405 US Medicare Beneficiaries

• Published in: Stroke (1970) Vol. 52; no. Suppl_1; p. AP631
• Main Authors: Brown, Scott C, Aitken, William, Lombard, Joanna, Wang, Kefeng, Rundek, Tatjana, Dong, Chuanhui, Gutierrez, Carolina M, Byrne, Margaret M, Toro, Matthew, Nardi, Maria, Kardys, Jack, Parrish, Abraham K, Szapocznik, Jose
• Format: Journal Article
• Language: English
• Published: Lippincott Williams & Wilkins 01-03-2021
• DOI: 10.1161/str.52.suppl_1.P631
• EISSN: 1524-4628
• ISSN: 0039-2499

IntroductionNature exposures represent a novel environmental protective factor for chronic disease, which is understudied with respect to stroke and transient ischemic attack. The purpose of the present study is to investigate the relationship between objectively measured neighborhood greenness (vegetative presence) and Stroke/Transient Ischemic Attack (Stroke/TIA), in a population-based sample of Medicare beneficiaries. MethodsThe sample was comprised of 249,405 U.S. Medicare beneficiaries ages >65 years with the same location (ZIP+4) in Miami-Dade County, Florida, from 2010-2011. Analyses examined the relationship of greenness, measured by mean block-level Normalized Difference Vegetation Index (NDVI) from satellite imagery, to a diagnosis of Stroke/TIA. Hierarchical regression analyses, in a multi-level framework, assessed the relationship of greenness to Stroke/TIA, adjusting successively for individual age, gender, race/ethnicity, neighborhood income, and biological risk factors (diabetes, hypertension, hyperlipidemia). Secondary analyses then examined the relationship of greenness separately for specific diagnoses of Transient Ischemic Attack (TIA), Ischemic Stroke, and Hemorrhagic Stroke, respectively. ResultsHigher greenness was associated with reduced risk for Stroke/TIA, adjusting for individual sociodemographics and neighborhood incomeWhen compared to individuals residing in the lowest tertile of greenness, those individuals residing in the highest tertile of greenness had a 20% lower odds of Stroke/TIA (OR=0.80; 95% CI0.74, 0.86, p<0.0001), as well as a 26% lower odds of TIA (OR=0.74; 95% CI0.66, 0.82; p<0.0001) and a 16% lower odds of Ischemic Stroke (OR=0.84; 95% CI0.75, 0.95; p=0.0050), but did not have a statistically significantly reduced odds of Hemorrhagic Stroke (OR=0.84; 95% CI0.61, 1.16; p=0.2990). Associations were attenuated after adjusting for biological risk factors, suggesting that cardiometabolic risk factors may partly mediate greenness’ relationship to stroke and TIA. ConclusionsNeighborhood greenness may be associated with reduced risk of Stroke/TIA. Policies and strategies to increase greenness may be a future means of reducing Stroke/TIA at the population level.