Study on the association between residential greenspace and risk of hypertension
Objective To evaluate the association of residential greenspace with hypertension and pre-hypertension in adult residents.Methods Using multi-stage stratified random sampling,adults were selected from a district in Bengbu,Anhui Province,whose socio-demographic characteristics and blood pressure levels were obtained through questionnaire interview and physical examination.Residential greenness exposure was assessed using the normalized difference vegetation index(NDVI)and optimized soil-adjusted vegetation index(OSAVI)within a 250m buffer around the participants'residences.Generalized linear mixed-effects model was used to evaluate the association between residential greenspace and hypertension/pre-hypertension,as well as the variability of the association.Mediation analysis was used to evaluate the mediation effect of body mass index(BMI)and PM2.5.Results Of the 2 940 adults included,955 were pre-hypertensive,with an overall prevalence of 32.48％,and 1 414 had hypertension,with an overall prevalence of 48.10％.After adjusting for covariates,residents in the fourth quartile of greenness exposure(the highest exposure)had a lower risk of pre-hypertension and hypertension compared with those in the first quartile of NDVI250 and OSAVI250(the lowest greenness exposure).Taking the normal blood pressure group as the reference group,the impact of residential greenspace on hypertension was larger than that on pre-hypertension.Mediation analysis showed that BMI mediated 13.36％(95％CI:4.00％-41.00％)and 16.92％(95％CI:3.90％-40.00％)of the negative association between NDVI250 and the risks of pre-hypertension,and between NDVI250 and hypertension,respectively;while no mediating role of PM2.5 was observed in the association between neighborhood greenspace and pre-hypertension/hypertension.Conclusions Higher level of neighborhood greenness may be associated with reduced risk of hypertension and pre-hypertension,in which BMI may be a mediating factor.
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