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

Jiang, Jie; Chen, Gongbo; Li, Baojing; Li, Na; Liu, Feifei; Lu, Yuanan; Lee, Hyewon; Li, Shanshan; Chen, Lifeng; Xiang, Hao

doi:10.1007/s11356-021-14201-0

Cited by 21 publications

(15 citation statements)

References 39 publications

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“…One of the most widely discussed mediators was air pollutants, including particulate matters, NO 2 , etc. Similar to previous studies ( Jiang et al, 2021 , Yang et al, 2021 ), we also found that PM 2.5 , PM 10, and NO 2 mediated the association between greenness and COVID-19 severity, particularly to NO 2 . Studies ( Sepehri et al, 2020 , Sepehri and Sarrafzadeh, 2019 ) suggested that this compound occurs in the aqueous media.…”

Section: Discussionsupporting

confidence: 92%

“…Recent studies ( Jiang et al, 2021 , Peng et al, 2021 , Xie et al, 2021 , Yang et al, 2021 ) conducting the association of greenness with health outcomes had attempted to uncover the potential mechanism through mediation analysis. One of the most widely discussed mediators was air pollutants, including particulate matters, NO 2 , etc.…”

Section: Discussionmentioning

confidence: 99%

“…The benefit effect of greenness on health outcome have been aroused great attention in recent years. A growing body of epidemiology studies has discussed the relationship between residential greenness and chronic non-infectious diseases, such as diabetes ( Li et al, 2021 , Yang et al, 2019b ), hypertension ( Jiang et al, 2021 , Yang et al, 2019a ) and cardiovascular diseases ( Jia et al, 2018 , Liu et al, 2021 ). Evidence regarding infectious diseases is still limited.…”

Section: Introductionmentioning

confidence: 99%

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Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China

Peng

Kan

Zhou

et al. 2022

Ecotoxicology and Environmental Safety

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Evidence regarding environmental factors associated with disease severity of COVID-19 remained scarce. This study aimed to investigate the association of residential greenness exposure with COVID-19 severity applying a retrospective cross-sectional study in Wuhan, China. We included 30253 COVID-19 cases aged over 45 years from January 1 to February 27, 2020. Residential greenness was quantitatively assessed using normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). A multilevel generalized linear model using Poisson regression was implemented to analyze the association between greenness exposure and disease severity of COVID-19, after adjusting for potential covariates. A linear exposure-response relationship was found between greenness and COVID-19 severity. In the adjusted model, one 0.1 unit increase of NDVI and EVI in the 1000-m buffer radius was significantly associated with a 7.6% (95% confidence interval (CI): 4.0%, 11.1%) and 10.0% (95% CI: 5.1%, 14.7%) reduction of the prevalence of COVID-19 severity, respectively. The effect of residential greenness seemed to be more pronounced among participants with lower population density and economic levels. Air pollutants mediated 0.82%~12.08% of the greenness and COVID-19 severity association, particularly to nitrogen dioxide. Sensitivity analyses suggested the robustness of the results. Our findings suggested that residential greenness exposure was beneficial to reduce the prevalence of COVID-19 severity.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China

Peng

Kan

Zhou

et al. 2022

Ecotoxicology and Environmental Safety

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“…Similarly, a longitudinal cohort study on the association between residential greenness and mortality reported a stronger association in never smokers (HR: 1.09, 95% CI 1.04–1.14) than in smokers (HR: 1.03, 0.91–1.17) [ 34 ]. In contrast, smokers benefitted more from the effects of greenness than never smokers with decreased blood pressure [ 35 ] and the prevalence of chronic kidney disease [ 36 ]. Therefore, both smokers and never-smokers can benefit from exposure to residential greenness.…”

Section: Discussionmentioning

confidence: 99%

Association between Residential Greenness and Incidence of Parkinson’s Disease: A Population-Based Cohort Study in South Korea

Jung

Park

Myung

et al. 2022

IJERPH

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It is widely known that exposure to residential greenness is beneficial for health. However, few studies have analyzed the association between greenery and Parkinson’s disease (PD). We selected 313,355 participants who matched the inclusion criteria from the National Health Insurance Service-National Sample Cohort, followed up from 2007 to 2015. Residential greenness, represented by the normalized difference vegetation index (NDVI), was obtained from satellite measurements. We estimated hazard ratios of PD associated with a 0.1-unit increase in long-term greenness exposure at the district level for the previous 1 year of each year until a censoring/event occurred, using time-varying Cox proportional hazard models, adjusted for individual- and area-level characteristics. During the 2,745,389 person-years of follow-up, 2621(0.8%) participants developed PD. Exposure to higher levels of residential greenness was found to be associated with a decreased risk of PD incidence (21% per 0.1-unit increase, 95% confidence interval (CI): 0.74–0.84). In subgroup analyses, stronger protective effects were observed in participants aged over 50 years, females, overweight/obese participants, non-urban residents, non-smokers, alcoholics, and those with comorbidities. Long-term exposure to greenness was beneficial to incident PD, and our findings could aid in the development of public-health strategies.

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“…Greenness usually comprises vegetation and is closely associated with natural elements [ 1 ]; it is a widely used environmental indicator in the medical and health sciences field. An increasing number of studies have confirmed that greenness is beneficial for cardiovascular health [ 2 , 3 ]. Greenness can offset the effects of environmental hazards and reduce damage to the cardio-cerebral vascular system caused by air pollutants, heat, and noise; greenness exposure can relieve mental stress as well as help reduce the proportion of overweight and obese individuals [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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

Zhou

Chen

et al. 2022

Environ Health

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Background Although the oldest-old (those aged over 80 years) are vulnerable to environmental factors and have the highest prevalence of hypertension, studies focusing on greenness exposure and the development of hypertension among them are insufficient. The aim of this study was to explore the association between residential greenness and hypertension in the oldest-old population. Methods This cohort study included data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The oldest-old were free of hypertension at baseline (2008), and hypertension events were assessed by follow-up surveys in 2011, 2014, and 2018. The one-year averages of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) at 500-m buffer before the interview year of incident hypertension or last censoring interview were collected at the level of 652 residential units (district or county). The linear or nonlinear association between greenness and hypertension incidence was analyzed using the Cox proportional hazards model with penalized splines. The linear links between greenness and hypertension incidence were determined using the Cox proportional hazards model included a random effect term. Results Among 5253 participants, the incidence rate of hypertension was 7.25 (95% confidence interval [CI]: 6.83–7.67) per 100 person-years. We found a nonlinear association between greenness exposure and hypertension risk, and the exposure-response curve showed that 1 change point existed. We examined the linear effect of greenness on hypertension by categorizing the NDVI/EVI into low and high-level exposure areas according to the change point. We found more notable protective effects of each 0.1-unit increase in greenness on hypertension incidence for participants living in the high-level greenness areas (hazard ratio (HR) = 0.60; 95% CI: 0.53–0.70 for NDVI; HR = 0.46; 95% CI: 0.37–0.57 for EVI). In contrast, no significant influence of greenness exposure on hypertension risk was found for participants living in the low-level greenness areas (HR = 0.77; 95% CI: 0.38–1.55 for NDVI; HR = 0.73; 95% CI: 0.33–1.63 for EVI). Conclusions Greenness exposure is nonlinearly associated with hypertension risk among the oldest-old, presenting its relationship in an inverse “U-shaped” curve. Greenness is a protective factor that decreases the risk of hypertension.

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

Cited by 21 publications

References 39 publications

Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China

Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China

Association between Residential Greenness and Incidence of Parkinson’s Disease: A Population-Based Cohort Study in South Korea

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

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