Curr Neurovasc Res. 2026 Oct 2. doi: 10.2174/0115672026460820260929113419. Online ahead of print.
ABSTRACT
Air pollution is an increasingly important public health concern in Pakistan, especially in rapidly urbanizing cities where concentrations of PM2.5, PM10, and other airborne toxicants frequently exceed recommended safety limits. Although the respiratory and cardiovascular consequences of air pollution are widely recognized, its contribution to neurovascular injury remains comparatively underrepresented in public health planning. This review synthesizes national and international evidence on the relationship between air pollution exposure and neurovascular outcomes, with particular emphasis on stroke-related mechanisms, cerebrovascular injury, and evidence gaps relevant to Pakistan and South Asia. Current evidence suggests that fine and ultrafine particulate matter may contribute to neurovascular damage through systemic inflammation, oxidative stress, endothelial dysfunction, blood-brain barrier disruption, microglial activation, vascular inflammation, atherosclerosis, and pro-thrombotic changes. These pathways provide biologically plausible links between chronic pollutant exposure and increased susceptibility to ischemic stroke, hemorrhagic stroke, cerebral small vessel disease, and impaired neurological recovery. However, Pakistan-specific longitudinal studies, biomarker-based investigations, and exposure-linked stroke surveillance data remain limited, restricting the integration of environmental exposure into neurovascular risk assessment and policy development. Given Pakistan's high pollution burden, dense urban populations, and increasing stroke-related morbidity, air pollution should be considered a potentially modifiable neurovascular risk factor. Strengthening air-quality monitoring, developing local epidemiological cohorts, integrating pollution exposure with hospital and stroke-registry data, and implementing targeted prevention strategies for high-risk populations may help reduce the future burden of pollution-associated neurovascular disease in Pakistan.
PMID:42861802 | DOI:10.2174/0115672026460820260929113419