Cardiovascular diseases in middle aged and older adults in China: the joint effects and mediation of different types of physical exercise and neighborhood greenness and walkability

Jia, Xiaofang; Yu, Ying; Xia, Wanning; Masri, Shahir; Sami, Mojgan; Hu, Zhixiong; Yu, Zhaoxia; Wu, Jun

doi:10.1016/j.envres.2018.07.003

Cited by 106 publications

(66 citation statements)

References 78 publications

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“…The health-promoting effects of green spaces may be due to stress mitigation, encouragement of physical activity, and facilitation of social contact [ 47 , 48 ]. Our results are in line with those of the recent studies reporting different levels of associations between exposure to green spaces and hypertension [ 16 , 17 , 49 , 50 , 51 , 52 ]. Possible inconsistencies in the reported effects of greenness on health are thought to be due to distance, socio-cultural factors, perceived safety [ 53 ], usage of different tools to assess the availability of green spaces [ 54 ], or different study designs [ 55 ].…”

Section: Discussionsupporting

confidence: 93%

“…Therefore, the evidence concerning the effects of greenness on hypertension remains mixed and inconclusive [ 12 , 15 ]. These studies used the community area classification method as an index of green space exposure, and very few of these studies examined the complex effects of the social environment and the built environment [ 16 , 17 ], or analyzed the influence of neighborhood characteristics on residents’ perceptions not including the health effects [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study

Gražulevičienė

Gražulevičius

Dėdelė

2020

IJERPH

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Citizens’ participation in urban environmental quality assessment is important when identifying local problems in the sustainable development and environmental planning policy. The principal aim of this study was to analyze whether any social differences exist between the joint effect of built neighborhood quality and exposure to urban green spaces and the risk of hypertension. The study sample consisted of 580 participants residing in 11 districts in Kaunas city, Lithuania. Using geographic information systems (GIS), individual data on the socioeconomic status (SES) and health were linked to the participants’ perceptions of the environmental quality and exposure to green spaces (NDVI). We used multivariate logistic regression to estimate associations as odds ratios (OR). Those study participants with lower education and those study participants with higher education on low incomes rated their health significantly worse. Low SES persons residing in areas with low exposure to green spaces had a significantly higher risk of hypertension when sex, age, family status, smoking, and income were accounted for (OR 1.83, 95% CI 1.01–3.36). This citizen science study provided evidence that the social environment and the quality of the built environment had a complex effect on disparities in the risk of hypertension.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study

Gražulevičienė

Gražulevičius

Dėdelė

2020

IJERPH

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“… 13 Another cross-sectional study of Chinese adults reported a substantial reduction in the likelihood of coronary heart disease and stroke among populations residing in areas with higher NDVI levels. 30 Similar results were reported by cross-sectional studies from the US, 36 Israel, 28 New Zealand, 14 and Brazil. 23 …”

Section: Discussionsupporting

confidence: 78%

“…Accumulating data indicate that a higher amount of neighborhood vegetation (referred to as residential greenness) is associated with a range of beneficial health outcomes. 3 , 4 A large number of studies have examined the cardiovascular associations of greenness, 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 but more than 50% of those focused on CVD mortality. In addition, most of the previous studies were conducted in middle- and high-income countries, and only a few studies were performed in low-income countries.…”

Section: Introductionmentioning

confidence: 99%

Association Between Residential Greenness, Cardiometabolic Disorders, and Cardiovascular Disease Among Adults in China

Yang

Jalaludin

et al. 2020

JAMA Netw Open

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Key Points Question Is the general vegetation level of a residential area, referred to as residential greenness, associated with cardiovascular disease among adults, and does the presence of cardiometabolic disorders mediate or modify the association between residential greenness and cardiovascular disease? Findings In this cross-sectional study of 24 845 adults in China, residential areas with higher greenness levels were associated with a lower likelihood of cardiovascular disease. The presence of cardiometabolic disorders partially mediated the association between residential greenness and cardiovascular disease. Meaning The study’s findings may be helpful for health care professionals and policy makers in the development of strategies, such as planning for green spaces in residential areas, to mitigate the burden of cardiovascular disease.

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“…Finally, the beneficial use of parks for cardiovascular health has been shown to be mediated by physical activity, social cohesion and the ecosystemic benefits of green areas [19]. The effects of green areas and land cover on health in megacities of low-middle income countries like Sao Paulo have been poorly studied [25,26].…”

Section: Introductionmentioning

confidence: 99%

Green Spaces, Land Cover, Street Trees and Hypertension in the Megacity of São Paulo

Moreira

Polizel

Santos

et al. 2020

IJERPH

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Proximity to green spaces has been shown to be beneficial to several cardiovascular outcomes in urban spaces. Few studies, however, have analyzed the relationship between these outcomes and green space or land cover uses in low–medium income megacities, where the consequences of rapid and inordinate urbanization impose several health hazards. This study used a subgroup of the dataset from The Brazilian Longitudinal Study of Adult Health ELSA-BRASIL (n = 3418) to identify the correlation between the medical diagnosis of hypertension and green spaces in the megacity of São Paulo. Land cover classification was performed based on the random forest algorithm using geometrically corrected aerial photography (orthophoto). Three different indicators of exposure to green spaces were used: number of street trees, land cover and number of parks within 1 km. We used logistic regression models to obtain the association of the metrics exposure and health outcomes. The number of street trees in the regional governments (OR = 0.937 and number of parks within 1 km (OR = 0.876) were inversely associated with a diagnosis of hypertension. Sixty-three percent of the population had no parks within 1 km of their residence. Our data indicate the need to encourage large-scale street tree planting and increase the number of qualified parks in megacities.

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Cardiovascular diseases in middle aged and older adults in China: the joint effects and mediation of different types of physical exercise and neighborhood greenness and walkability

Cited by 106 publications

References 78 publications

Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study

Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study

Association Between Residential Greenness, Cardiometabolic Disorders, and Cardiovascular Disease Among Adults in China

Green Spaces, Land Cover, Street Trees and Hypertension in the Megacity of São Paulo

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