☆ 4.5 Review

Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review

JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE (2023)

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Urban greenness and hypertension among Ghanaian adults

Kwadwo A. Boakye et al.

Summary: There is a lack of studies on the relationship between greenness and hypertension in sub-Saharan African countries, specifically Ghana. This study used Greenness (Enhanced Vegetation Index, EVI) data and found that participants with higher exposure to greenness had lower odds of hypertension. These findings suggest the importance of preserving green spaces and allocating them in urban areas undergoing rapid urbanization.

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Precision Greenness and Stroke/Transient Ischemic Attack in 249,405 US Medicare Beneficiaries

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Review Cardiac & Cardiovascular Systems

Favorable Neighborhood Walkability is Associated With Lower Burden of Cardiovascular Risk Factors Among Patients Within an Integrated Health System: The Houston Methodist Learning Health System Outpatient Registry

Omar Mohamed Makram et al.

Summary: This is the first study to investigate the relationship between neighborhood walkability and cardiovascular risk factors in the United States using a large population-based database. The study found that residents of neighborhoods with higher walkability had significantly lower prevalence of cardiovascular risk factors. These findings support multilevel health system stakeholder engagements and investments in walkable neighborhoods as a viable tool for mitigating the growing burden of modifiable cardiovascular risk factors.

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Article Environmental Sciences

Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand

Kanawat Paoin et al.

Summary: This study examined the association between long-term exposure to residential greenness and self-reported morbidities in participants of the Thai Cohort Study. The findings suggest that long-term exposure to green environments may reduce the risk of high blood pressure, high blood cholesterol, and diabetes.

ENVIRONMENTAL RESEARCH (2023)

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Article Public, Environmental & Occupational Health

Nine-year exposure to residential greenness and the risk of metabolic syndrome among Luxembourgish adults: A longitudinal analysis of the ORISCAV-Lux cohort study

Marion Tharrey et al.

Summary: Growing evidence suggests that exposure to greenspace has a positive effect on cardiometabolic health. This study investigated the long-term associations between residential greenness exposure and metabolic syndrome (MetS) and its components. Objective measures of greenness were used, and an increase in Soil-Adjusted Vegetation Index (SAVI) was found to help prevent MetS and improve HDL-cholesterol and fasting plasma glucose levels. However, the impact of increased greenness on cardiometabolic outcomes was mixed. Further longitudinal research is needed to better understand the effects of different types of greenness exposure.

HEALTH & PLACE (2023)

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Article Environmental Sciences

Residential greenness-related DNA methylation changes

Ayoung Jeong et al.

Summary: Residential greenness is associated with DNA methylation profiles, with greenness-related profiles showing enrichments in allergy, physical activity, and allostatic load. This suggests that residential greenness may impact health through allergic sensitization, stress coping, or behavioral changes.

ENVIRONMENT INTERNATIONAL (2022)

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Article Environmental Sciences

Associations of residential walkability and greenness with arterial stiffness in the UK Biobank

Ka Yan Lai et al.

Summary: The study revealed a negative association between residential walkability and greenness with arterial stiffness, indicating that designing more walkable and greener residential environments could help lower the population distribution of vascular ageing and associated cardiovascular risks.

ENVIRONMENT INTERNATIONAL (2022)

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Article Environmental Sciences

Interaction between walkability and fine particulate matter on risk of ischemic stroke: A prospective cohort study in China

Zongming Yang et al.

Summary: Living in walkable neighborhoods is associated with a lower risk of ischemic stroke, but this benefit may be offset by the adverse effects of PM2.5 exposure in highly polluted areas. There is a significant interaction between walkability and PM2.5, with the association between walkability and ischemic stroke risk varying at different PM2.5 concentrations. These findings have implications for future neighborhood design, air pollution control, and stroke prevention efforts.

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Social and built neighborhood environments and blood pressure 6 years later: Results from the Hispanic Community Health Study/Study of Latinos and the SOL CASAS ancillary study

Kimberly L. Savin et al.

Summary: Neighborhood-level socioeconomic deprivation and social disorder may have adverse effects on blood pressure among Hispanic/Latino communities.

SOCIAL SCIENCE & MEDICINE (2022)

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Air pollution and surrounding greenness in relation to ischemic stroke: A population-based cohort study

C. Avellaneda-Gomez et al.

Summary: This study assessed the relationship between exposure to air pollutants, residential surrounding greenness, and incident ischemic stroke (IS). The findings suggest that long-term exposure to air pollution, particularly nitrogen dioxide (NO2), increases the risk of IS, while larger residential surrounding green spaces are associated with a lower incidence of IS.

ENVIRONMENT INTERNATIONAL (2022)

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Article Environmental Sciences

Multisite greenness exposure and oxidative stress in children. The potential mediating role of physical activity

Giulia Squillacioti et al.

Summary: Residential greenness exposure has a positive impact on health by reducing oxidative stress in children, and physical activity does not mediate this association.

ENVIRONMENTAL RESEARCH (2022)

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Article Environmental Sciences

The effects of greenness exposure on hypertension incidence among Chinese oldest-old: a prospective cohort study

Zhou Wensu et al.

Summary: This study explores the association between residential greenness and hypertension in the oldest-old population using data from the Chinese Longitudinal Healthy Longevity Survey. The findings suggest that greenness exposure is nonlinearly associated with hypertension risk among the oldest-old, acting as a protective factor against hypertension.

ENVIRONMENTAL HEALTH (2022)

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Article Environmental Sciences

Exploring the impacts of street-level greenspace on stroke and cardiovascular diseases in Chinese adults

Ruoyu Wang et al.

Summary: This study finds that street-level greenspace exposure is associated with lower prevalence of cardiovascular diseases (CVDs), especially among females. The findings suggest the need to increase street-level vegetation to address the rapid growth of CVD burdens and consider the differences between the effects of street-level trees and grasses in urban planning policies.

ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY (2022)

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Associations between greenness and blood pressure and hypertension in Chinese middle-aged and elderly population: A longitudinal study

Teng Yang et al.

Summary: This study found an association between greenness and blood pressure and hypertension risk through a longitudinal study. Areas with higher greenness had lower blood pressure and lower risk of hypertension. This association was stronger in younger individuals and partially mediated by body mass index.

ENVIRONMENTAL RESEARCH (2022)

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Hypertension Defined by 2017 ACC/AHA Guideline, Ideal Cardiovascular Health Metrics, and Risk of Cardiovascular Disease: A Nationwide Prospective Cohort Study

Shujing Wu et al.

Summary: This study examines the association between updated blood pressure categories and the risk of cardiovascular diseases, and finds that improving cardiovascular health can attenuate the risk of cardiovascular events in individuals with stage 1 hypertension, especially in adults under the age of 60.

LANCET REGIONAL HEALTH-WESTERN PACIFIC (2022)

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Article Environmental Sciences

Joint associations between neighborhood walkability, greenness, and particulate air pollution on cardiovascular mortality among adults with a history of stroke or acute myocardial infarction

Noelle S. Liao et al.

Summary: This study examined the joint effects of walkability, greenness, and PM2.5 on cardiovascular disease (CVD) mortality. The findings suggest that higher levels of greenness may have a protective effect on CVD mortality among adults with a history of CVD. PM2.5 had a strong independent effect on CVD mortality, and there was a slight variation in the associations between PM2.5 and CVD mortality based on the level of neighborhood walkability.

ENVIRONMENTAL EPIDEMIOLOGY (2022)

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Article Environmental Sciences

Joint associations between neighborhood walkability, greenness, and particulate air pollution on cardiovascular mortality among adults with a history of stroke or acute myocardial infarction

Noelle S. Liao et al.

Summary: Greenness has a nonlinear association with CVD mortality, with higher greenness levels being protective for individuals with a history of CVD. Walkability does not have an independent effect on CVD mortality. PM2.5 has a significant independent effect on CVD mortality and its association varies slightly in more walkable neighborhoods.

ENVIRONMENTAL EPIDEMIOLOGY (2022)

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Residential proximity to greenness mitigates the hemodynamic effects of ambient air pollution

Daniel W. Riggs et al.

Summary: Residential proximity to greenness is associated with lower risk of cardiovascular disease and reduced effects of air pollutants on arterial stiffness. In areas with low greenness, PM2.5 and ozone were positively associated with arterial stiffness, while in areas with high greenness, this association was not significant. This suggests that living in green neighborhoods can mitigate the adverse cardiovascular effects of air pollution.

AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY (2021)

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Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA

Melissa N. Poulsen et al.

Summary: The study investigated the association between residential greenness and blood pressure among individuals with type 2 diabetes, finding a significant reduction in systolic and diastolic blood pressure in the greenest communities (townships). The results suggest a threshold effect with high greenness possibly being necessary to influence blood pressure in this population, supporting a slight beneficial impact of greenness on cardiovascular disease risk.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2021)

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Objectively Measured Built Environments and Cardiovascular Diseases in Middle-Aged and Older Korean Adults

Eun Young Lee et al.

Summary: This study found that creating a built environment that provides more opportunities for physical activity in daily life may help reduce the prevalence of cardiovascular diseases.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2021)

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Neighborhood Walkability as a Predictor of Incident Hypertension in a National Cohort Study

Alana C. Jones et al.

Summary: This study investigated the association between neighborhood walkability and incident hypertension, finding that living in more walkable neighborhoods was associated with a lower risk of developing hypertension. The results suggest that increased neighborhood walkability may be protective against high blood pressure.

FRONTIERS IN PUBLIC HEALTH (2021)

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Article Environmental Sciences

Google Street View-Derived Neighborhood Characteristics in California Associated with Coronary Heart Disease, Hypertension, Diabetes

Thu T. Nguyen et al.

Summary: The characteristics of the neighborhood built environment have an impact on health outcomes and behaviors. Research has shown that communities with higher levels of greenery have lower prevalence of coronary artery disease, hypertension, and diabetes, while visible utility wires and dilapidated buildings are associated with higher rates of these chronic diseases. Google Street View images and computer vision models can provide insights into contextual factors influencing patient health outcomes.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2021)

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Article Medicine, General & Internal

Liveable residential space, residential density, and hypertension in Hong Kong: A population-based cohort study

Chinmoy Sarkar et al.

Summary: This study examined the impacts of liveable residential space and density on hypertension in adults using a large cohort in Hong Kong. Results showed that larger liveable spaces and higher residential density were associated with lower odds of hypertension.

PLOS MEDICINE (2021)

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Article Environmental Sciences

Greenness-air pollution-physical activity-hypertension association among middle-aged and older adults: Evidence from urban and rural China

Baishi Huang et al.

Summary: Higher residential greenness is directly related to a lower prevalence of hypertension among middle and older aged adults in rural China but not in urban areas. In urban areas, the association of greenness with hypertension is completely mediated by PM2.5 concentrations, while in rural areas, it is partially mediated by PM2.5 concentrations, PM2.5 concentrations-physical activity path, and other factors.

ENVIRONMENTAL RESEARCH (2021)

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Article Environmental Sciences

Associations of residential greenness with hypertension and blood pressure in a Chinese rural population: a cross-sectional study

Jie Jiang et al.

Summary: Limited epidemiological literature has identified the associations between residential greenness and hypertension in low-/middle-income countries. A study in central China involving 39,259 residents found that higher residential greenness was associated with lower odds of hypertension and blood pressure levels, with a more pronounced effect in males, smokers, and drinkers. Long-term exposure to residential greenness was linked with lower odds of hypertension, indicating the need for further prospective studies for verification.

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Green space and mortality in European cities: a health impact assessment study

Evelise Pereira Barboza et al.

Lancet Planetary Health (2021)

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Neighborhood Walkability and Mortality in a Prospective Cohort of Women

Sandra India-Aldana et al.

Summary: The study found that living in neighborhoods with higher walkability scores was associated with lower mortality rates, especially in terms of obesity-related cancer deaths. Outdoor walking and average BMI may mediate the association between neighborhood walkability and mortality.

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Community design and hypertension: Walkability and park access relationships with cardiovascular health

Binay Adhikari et al.

Summary: This study examined the relationship between features of the built and natural environments and hypertension, finding that higher levels of walkability and park accessibility were associated with significantly lower odds of self-reported hypertension, with obesity playing a key mediating role in this relationship. Longitudinal research is needed to further explore the causal effects of built and natural environments on hypertension.

INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH (2021)

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The relationship between neighbourhood walkability and cardiovascular risk factors in northern France

Antoine de Courreges et al.

Summary: The study found that residing in a more walkable neighborhood was associated with a lower prevalence of vascular risk factors, which may help improve cardiovascular health in the population.

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HEALTH & PLACE (2013)

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Review Cardiac & Cardiovascular Systems

Effects of Physical Activity on Cardiovascular Disease

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AMERICAN JOURNAL OF CARDIOLOGY (2012)

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Sleep disturbance and cardiovascular risk in adolescents

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CANADIAN MEDICAL ASSOCIATION JOURNAL (2012)

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Article Cardiac & Cardiovascular Systems

Role of Built Environments in Physical Activity, Obesity, and Cardiovascular Disease

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CIRCULATION (2012)

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A cohort study relating urban green space with mortality in Ontario, Canada

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ENVIRONMENTAL RESEARCH (2012)

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NATURE REVIEWS CARDIOLOGY (2012)

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Review Nutrition & Dietetics

Using Geographic Information Systems (GIS) to assess the role of the built environment in influencing obesity: a glossary

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INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY (2011)

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Arterial Stiffness and Cardiovascular Events The Framingham Heart Study

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CIRCULATION (2010)

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Urban built environments and trajectories of mobility disability: Findings from a national sample of community-dwelling American adults (1986-2001)

Philippa Clarke et al.

SOCIAL SCIENCE & MEDICINE (2009)

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Article Medicine, General & Internal

Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies

Pasquale Strazzullo et al.

BMJ-BRITISH MEDICAL JOURNAL (2009)

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The relationship between destination proximity, destination mix and physical activity behaviors

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PREVENTIVE MEDICINE (2008)

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Urban as a Determinant of Health

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JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE (2007)

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Nutrition, physical activity, and cardiovascular disease: An update

Louis J. Ignarro et al.

CARDIOVASCULAR RESEARCH (2007)

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Article Public, Environmental & Occupational Health

Multi-level modelling in health research: A caution and rejoinder on temporally mismatched data

M Buzzelli et al.

SOCIAL SCIENCE & MEDICINE (2006)

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Cities and population health

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SOCIAL SCIENCE & MEDICINE (2005)

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Cardiorespiratory fitness, physical activity, and arterial stiffness - The Northern Ireland Young Hearts Project

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HYPERTENSION (2004)

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Neighborhood-based differences in physical activity: An environment scale evaluation

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AMERICAN JOURNAL OF PUBLIC HEALTH (2003)

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The molecular genetics of cardiovascular disease: clinical implications

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JOURNAL OF INTERNAL MEDICINE (2003)

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Science, medicine, and the future - Genetics and cardiovascular risk

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BRITISH MEDICAL JOURNAL (2001)

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Review Peripheral Vascular Disease

Role of oxidative stress in cardiovascular diseases

NS Dhalla et al.

JOURNAL OF HYPERTENSION (2000)

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