Abstract
BACKGROUND: Green space has been linked with cardiovascular (CV) health. Nature access and quality may have significant impact on CV risk factors and health.
OBJECTIVES: The authors aimed to investigate the relationship between NatureScore, a composite score for natural environment exposure and quality of green spaces, with CV risk factors and atherosclerotic cardiovascular diseases (ASCVD).
METHODS: A cross-sectional study including one million adult patients from the Houston Methodist Learning Health System Outpatient Registry (2016-2022). NatureScore is a composite measure of natural environment exposure and quality (0-100) calculated for each patient based on residential address. NatureScores was divided into 4 categories: nature deficient/light (0-39), nature adequate (40-59), nature rich (60-79), and nature utopia (80-100). CV risk factors included hypertension, diabetes, dyslipidemia, and obesity.
RESULTS: Among 1.07 million included patients (mean age 52 years, female 59%, Hispanic 16%, Non-Hispanic Black 14%), median NatureScore was 69.4. After adjusting for neighborhood walkability, patients living in highest NatureScore neighborhoods had lower prevalence of CV risk factors (OR: 0.91, 95% CI: 0.90-0.93) and ASCVD (OR: 0.96, 95% CI: 0.93-0.98) than those in lowest NatureScore neighborhoods. A significant interaction existed between NatureScore and Walkability ( P < 0.001), where those in high NatureScore (≥60) high walkability (≥40) areas had lower prevalence of CV risk factors (OR: 0.93, 95% CI: 0.90-0.97, P < 0.001) and were more likely to have optimal CV risk profile (relative risk ratio: 1.09, 95% CI: 1.04-1.14, P = 0.001).
CONCLUSIONS: These findings suggest that while green spaces benefit health, their accessibility through walkable environments is crucial for cardiovascular disease protection.
Original language | English (US) |
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Article number | 101457 |
Pages (from-to) | 101457 |
Journal | JACC: Advances |
Volume | 4 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2025 |
Keywords
- cardiovascular
- diabetes
- hypertension
- nature
- walkability
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine