Exposure to green spaces, cardiovascular risk biomarkers and incident cardiovascular disease in older adults: The Seniors-Enrica II cohort.

Autor: Scheer C; Fulda University of Applied Sciences. Fulda, Germany., Plans-Beriso E; Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Pastor-Barriuso R; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Ortolá R; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid. Madrid, Spain/ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Sotos-Prieto M; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid. Madrid, Spain/ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain., Cabañas-Sánchez V; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid. Madrid, Spain/ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Gullón P; Department of Surgery, Social and Medical Sciences. School of Medicine and Health Sciences, Universidad de Alcala. Alcala de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia., Ojeda Sánchez C; Guadalajara University Hospital. Guadalajara, Spain., Ramis R; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Fernández-Navarro P; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Rodríguez-Artalejo F; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain., García-Esquinas E; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address: egarciag@isciii.es.
Jazyk: angličtina
Zdroj: Environment international [Environ Int] 2024 Mar; Vol. 185, pp. 108570. Date of Electronic Publication: 2024 Mar 12.
DOI: 10.1016/j.envint.2024.108570
Abstrakt: Introduction: The impact of residential green spaces on cardiovascular health in older adults remains uncertain.
Methods: Cohort study involving 2114 adults aged ≥ 65 years without cardiovascular disease (CVD), residing in five dense municipalities (Prince et al., 2015) of the Madrid region and with detailed characterization of their socioeconomic background, health behaviors, CVD biological risk factors, and mental, physical, and cognitive health. Greenness exposure was measured using the Normalized Difference Vegetation Index (NDVI) at varying distances from participants' homes. Traffic exposure, neighborhood environment, neighborhood walkability, and socioeconomic deprivation at the census level were also assessed. Serum N-terminal pro-B-type natriuretic peptide (NT-ProBNP), high-sensitivity troponin T (hs-TnT), interleukin 6 (IL-6), and Growth Differentiation Factor 15 (GDF-15) were measured at baseline, and incident CVD events identified through electronic medical records (International Classification of Primary Care-2 codes K74, K75, K77, K90, and K92).
Results: After adjusting for sex, age, educational attainment, financial hardship and socioeconomic deprivation at the census level, an interquartile range (IQR) increase in NDVI at 250, 500, 750, and 1000 m around participants' homes was associated with mean differences in ProBNP of -5.56 % (95 %CI: -9.77; -1.35), -5.05 % (-9.58; -0.53), -4.24 % (-8.19, -0.19), and -4.16 % (-7.59; -0.74), respectively; and mean differences in hs-TnT among diabetic participants of -8.03 % (95 %CI: -13.30; -2.77), -9.52 % (-16.08; -2.96), -8.05 % (-13.94, -2.16) and -5.56 % (-10.75; -0.54), respectively. Of similar magnitude, although only statistically significant at 250 and 500 m, were the observed lower IL-6 levels with increasing greenness. GDF-15 levels were independent of NDVI. In prospective analyses (median follow-up 6.29 years), an IQR increase in residential greenness at 500, 750, and 1000 m was associated with a lower risk of incident CVD. The variables that contributed most to the apparent beneficial effects of greenness on CVD were lower exposure to traffic, improved cardiovascular risk factors, and enhanced physical performance. Additionally, neighborhood walkability and increased physical activity were notable contributors among individuals with diabetes.
Conclusion: Increased exposure to residential green space was associated with a moderate reduction in CVD risk in older adults residing in densely populated areas.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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