ABSTRACT NUMBER: ESOC2026A991 ATMOSPHERIC PRESSURE AND STROKE INCIDENCE: A SYSTEMATIC REVIEW

Abstract Background and aims Whilst research exists regarding meteorological influences on stroke incidence, systematic reviews assessing an association between atmospheric pressure (AP) and stroke incidence appear dated, limited in number and present inconsistent conclusions. This systematic review aimed to synthesise and evaluate evidence from studies assessing an association between AP and stroke incidence. Methods MEDLINE, Embase and Scopus databases were searched in October 2025. Two reviewers independently undertook screening, data extraction and critical appraisal, with conflicts resolved collaboratively. The developed inclusion and exclusion criteria employed in screening ensured relevance of the results to stroke departments structured similarly to the UK. Narrative synthesis was used due to variable reporting and methodological heterogeneity amongst included studies. Results 30 observational studies were identified for inclusion, totalling at least 547,775 stroke cases (94.3% ischaemic and 5.7% primary intracerebral haemorrhage). Critical appraisal showed varying study quality. Available study results were tabulated by stroke type, AP variable (mean/median, change in or maximum/minimum) and time period prior to the stroke event under investigation, resulting in six main results groupings. Conclusions Overall, the findings were largely unclear, with limited evidence for some associations such as increased stroke risk with AP change the previous day for both stroke types. Future research may further investigate these associations. Most importantly, the review highlighted challenges in synthesising and forming conclusions from research with greatly heterogeneous design, statistical analysis, and results organisation. The key implication is for improved standardisation of methods and reporting for studies investigating an AP-stroke incidence association to facilitate their synthesis and interpretation. Conflict of interest Shruti Anand Virgincar: nothing to disclose. Maya Bethany Slee: nothing to disclose. Bander Dallol: nothing to disclose.