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- Publisher Website: 10.1007/s11524-023-00764-5
- Scopus: eid_2-s2.0-85167910768
- WOS: WOS:001048081900006
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Article: Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review
Title | Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review |
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Authors | |
Keywords | Arterial stiffness Built environment CVD events, CVD mortality Greenspace Hypertension Walkability |
Issue Date | 14-Aug-2023 |
Publisher | Springer |
Citation | Journal of Urban Health, 2023, v. 100, n. 4, p. 745-787 How to Cite? |
Abstract | With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as “probably high” risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as “probably high” risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities. |
Persistent Identifier | http://hdl.handle.net/10722/331230 |
ISSN | 2023 Impact Factor: 4.3 2023 SCImago Journal Rankings: 1.673 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lai, Ka Yan | - |
dc.contributor.author | Webster, Chris | - |
dc.contributor.author | Gallacher, John | - |
dc.contributor.author | Sarkar, Chinmoy | - |
dc.date.accessioned | 2023-09-21T06:53:54Z | - |
dc.date.available | 2023-09-21T06:53:54Z | - |
dc.date.issued | 2023-08-14 | - |
dc.identifier.citation | Journal of Urban Health, 2023, v. 100, n. 4, p. 745-787 | - |
dc.identifier.issn | 1099-3460 | - |
dc.identifier.uri | http://hdl.handle.net/10722/331230 | - |
dc.description.abstract | <p>With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as “probably high” risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as “probably high” risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities.<br></p> | - |
dc.language | eng | - |
dc.publisher | Springer | - |
dc.relation.ispartof | Journal of Urban Health | - |
dc.subject | Arterial stiffness | - |
dc.subject | Built environment | - |
dc.subject | CVD events, CVD mortality | - |
dc.subject | Greenspace | - |
dc.subject | Hypertension | - |
dc.subject | Walkability | - |
dc.title | Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review | - |
dc.type | Article | - |
dc.identifier.doi | 10.1007/s11524-023-00764-5 | - |
dc.identifier.scopus | eid_2-s2.0-85167910768 | - |
dc.identifier.volume | 100 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 745 | - |
dc.identifier.epage | 787 | - |
dc.identifier.eissn | 1468-2869 | - |
dc.identifier.isi | WOS:001048081900006 | - |
dc.identifier.issnl | 1099-3460 | - |