Association Between Residential Greenness and Cardiovascular Disease Risk

Abstract

Background Exposure to green vegetation has been linked to positive health, but the pathophysiological processes affected by exposure to vegetation remain unclear. To study the relationship between greenness and cardiovascular disease, we examined the association between residential greenness and biomarkers of cardiovascular injury and disease risk in susceptible individuals. Methods and Results In this cross‐sectional study of 408 individuals recruited from a preventive cardiology clinic, we measured biomarkers of cardiovascular injury and risk in participant blood and urine. We estimated greenness from satellite‐derived normalized difference vegetation index ( NDVI ) in zones with radii of 250 m and 1 km surrounding the participants’ residences. We used generalized estimating equations to examine associations between greenness and cardiovascular disease biomarkers. We adjusted for residential clustering, demographic, clinical, and environmental variables. In fully adjusted models, contemporaneous NDVI within 250 m of participant residence was inversely associated with urinary levels of epinephrine (−6.9%; 95% confidence interval, −11.5, −2.0/0.1 NDVI ) and F2‐isoprostane (−9.0%; 95% confidence interval, −15.1, −2.5/0.1 NDVI ). We found stronger associations between NDVI and urinary epinephrine in women, those not on β‐blockers, and those who had not previously experienced a myocardial infarction. Of the 15 subtypes of circulating angiogenic cells examined, 11 were inversely associated (8.0–15.6% decrease/0.1 NDVI ), whereas 2 were positively associated (37.6–45.8% increase/0.1 NDVI ) with contemporaneous NDVI . Conclusions Independent of age, sex, race, smoking status, neighborhood deprivation, statin use, and roadway exposure, residential greenness is associated with lower levels of sympathetic activation, reduced oxidative stress, and higher angiogenic capacity.

Urban green space, tree canopy and prevention of cardiometabolic diseases: a multilevel longitudinal study of 46 786 Australians

“… 23 Three cross-sectional studies in China, 24 The Netherlands 22 and Austria 25 reported lower odds of prevalent hypertension among people living near more green space, with the latter also finding similar results specifically for increased tree canopy within 1000 m. Only one longitudinal study of green space and incident hypertension had been previously conducted, finding no association in Australia. 23 Three studies of prevalent CVD and green space had been conducted, each finding affirmative results in The Netherlands, 22 the USA 26 and China. 24 One longitudinal study in Lithuania observed a lower risk of fatal and non-fatal CVD events among people living closer to a green space.…”

APOE ε4 Modifies Effect of Residential Greenness on Cognitive Function among Older Adults: A Longitudinal Analysis in China

“…APOE ε4 allele carriage was related to higher risks of atherosclerosis. However, residential greenness was independently related to lower levels of sympathetic activation, reduced oxidative stress, and higher angiogenic capacity, which ultimately benefited atherosclerosis 31 . Additionally, residential greenness might affect cognitive function through the promoted physical activity 32 , and reduced environmental pollution 33 .…”

Density of Green Spaces and Cardiovascular Risk Factors in the City of Madrid: The Heart Healthy Hoods Study

“…Previous evidence linked residential green spaces with cardiovascular health and cardiovascular risk factors. There is evidence that a high amount of green spaces is associated with a decrease in cardiovascular mortality [16], a lower hazard of CVD [17], a lower cardiovascular risk [18], and some cardiovascular risk factors, such as obesity [19] and high blood pressure [20]. However, there is no consistent pattern of associations with cardiovascular risk factors, especially in adults, as some studies found green spaces to be associated with a decrease in CVD risk factors while others found no associations [12,13].…”