Residential area greenness and hypertension: a national assessment on urban adults in Bangladesh

This study investigated the associations between greenness and blood pressure (BP) metrics (systolic BP [SBP], diastolic BP [DBP], hypertension) among urban adults in Bangladesh and the potential mediation effects of body mass index (BMI) using 2011 Bangladesh Demographic and Health Survey data for 2360 urban adults (aged >= 35 years). The Enhanced Vegetation Index was used as a measure of residential area greenness. Associations between greenness and BP metrics were estimated using linear and binary logistic regression models. We also conducted mediation analyses. Greater area-level greenness was inversely associated with SBP (beta -1.33, 95%CI: -2.46, -.20), DBP (beta -.83, 95%CI: -1.64, -.02), and hypertension (adjusted odds ratio .87, 95%CI: .77, .98). BMI substantially mediated associations between greenness and BP metrics. Adopting urban greening policies could reduce the risk of hypertension, thus can contribute to reduction of non-communicable disease burden in Bangladesh. Longitudinal studies are required to further investigate the causal pathways.

Automated summary

This study investigated the associations between urban greenness and blood pressure metrics among adults in Bangladesh and found an inverse relationship between greenness and systolic blood pressure, diastolic blood pressure, and hypertension. The study also highlighted the mediating role of body mass index in these associations. Adopting urban greening policies could potentially reduce the risk of hypertension and contribute to the reduction of non-communicable disease burden in Bangladesh.