Higher transportation noise exposure was associated with a higher rate of stroke recurrence (HR, 1.36 [95% CI, 1.01 to 1.82]) but was not associated with initial stroke severity or all-cause mortality among ischemic stroke patients.
Key Findings
Results
Higher transportation noise exposure was significantly associated with a higher rate of stroke recurrence after adjustments.
Hazard ratio for stroke recurrence comparing high (75th percentile) versus low (25th percentile) noise exposure: HR 1.36 (95% CI, 1.01 to 1.82); P=0.04
176 patients (7.2%) experienced a recurrent stroke during follow-up
Median follow-up for stroke recurrence was 2.2 years (IQR, 0.7–4.3)
Estimates were scaled to the interquartile range of noise exposure
Cox proportional hazards models were used for recurrence analysis
Results
Higher transportation noise exposure was not associated with initial stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS).
Estimated difference in NIHSS score: -5% (95% CI, -12% to 2%); P=0.14
Median NIHSS score in the cohort was 3.0 (IQR, 1.0–7.0)
Linear regression was used to evaluate stroke severity
The association was evaluated among 2441 patients with acute incident ischemic stroke
Results
Higher transportation noise exposure was not significantly associated with all-cause mortality after adjustments.
Hazard ratio for mortality: HR 1.08 (95% CI, 0.94 to 1.24); P=0.26
818 patients (33.5%) died during follow-up
Median follow-up for mortality was 2.5 years (IQR, 0.8–4.6)
Cox proportional hazards models were used for mortality analysis
Methods
The study cohort consisted of 2441 patients with acute incident ischemic stroke enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) Project from 2016 to 2023.
This was a prospective cohort study design
Transportation noise exposure was derived from US Department of Transportation data from 2016 and 2018
Noise was defined as the maximum area-weighted noise level within a 100-m buffer of the residential address
Median transportation noise was 45.5 dB (IQR, 0.0–56.5 dB)
Background
Transportation noise remains understudied as a potential risk factor for poststroke outcomes in the United States.
The study authors describe this as a gap in the existing literature
The study evaluated three distinct poststroke outcomes: initial stroke severity, stroke recurrence, and all-cause mortality
The authors conclude that 'transportation noise may be an environmental risk factor for stroke recurrence, underscoring the need for policies addressing noise exposure'
What This Means
This research followed 2,441 people who had an ischemic stroke (caused by a blocked blood vessel) in Corpus Christi, Texas between 2016 and 2023. Researchers measured the level of transportation noise—such as from roads, railways, and airports—near each patient's home and then tracked what happened to the patients over time, including how severe their initial stroke was, whether they had another stroke, and whether they died.
The study found that people living in areas with higher transportation noise were significantly more likely to have a second stroke. Specifically, patients in higher-noise areas had about a 36% greater rate of stroke recurrence compared to those in lower-noise areas. However, noise exposure was not linked to how severe the initial stroke was or to the overall risk of dying during the follow-up period, which averaged about 2–2.5 years.
This research suggests that environmental noise from transportation may play a role in brain health outcomes after stroke, potentially acting as a stressor that raises the risk of having another stroke. This adds to a growing body of evidence that noise pollution is not just an annoyance but may have real health consequences. The findings point to a possible need for public health policies aimed at reducing transportation noise exposure, particularly for people who have already had a stroke and are at higher risk for recurrence.
Nanavati H, Adar S, Jin T, Chen C, Becker C, Morgenstern L, et al.. (2026). Association Between Transportation Noise Exposure and Poststroke Outcomes: Population-Based Brain Attack Surveillance in Corpus Christi Project.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.126.051242