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Associations of residential greenness with hypertension and blood pressure in a Chinese rural population: a cross-sectional study

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Abstract

Limited epidemiological literature identified the associations between residential greenness and hypertension in low-/middle-income countries. A random sampling strategy was adopted to recruit 39,259 residents, ≥ 18 years, and from 5 counties in central China. Blood pressure was measured based on the protocol of the American Heart Association. Hypertension was defined according to the 2010 Chinese guidelines for the management of hypertension. The satellite-derived normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were applied to estimate the residential greenness. Mixed logit model and mixed linear model were utilized to explore the relationships of residential greenness with hypertension and blood pressure. Higher residential greenness was associated with lower odds of hypertension and blood pressure levels. For instance, an interquartile range (IQR) increase in NDVI500m was linked with lower odds of hypertension (OR = 0.92, 95%CI 0.88 to 0.95), a decrease of −0.88 mm Hg (95% CI −1.17 to −0.58) and −0.64 mm Hg (95% CI −0.82 to −0.46) in SBP and DBP, respectively. The effect of residential greenness was more pronounced in males, smokers, and drinkers. Long-term exposure to residential greenness was linked with lower odds of hypertension. More prospective studies are needed to verify the hypothesis.

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Upon reasonable request, data are available from the corresponding author.

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Acknowledgements

We acknowledge the participants in the study.

Funding

Our work was funded by the National Natural Science Foundation of China (81903279), the Bill & Melinda Gates Foundation (OOP1148464), and the Hubei Province Natural Science Foundation (2018CFB634). Dr. Guo was supported by the Career Development Fellowship of the Australian National Health and Medical Research Council (ANHMRC) (APP1107107). Dr. S. Li was supported by the Early Career Fellowship of ANHMRC (APP1109193).

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Contributions

JJ: analysis, visualization, writing manuscript; GC: methodology, interpretation; BL: interpretation; NL: analysis, data curation; FL: validation, data curation; YL: methodology, supervision; YG: validation, funding acquisition; SL: methodology, funding acquisition; LC: visualization, methodology; HX: editing, funding acquisition. All authors read and approved the final manuscript.

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Correspondence to Lifeng Chen or Hao Xiang.

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This study was approved by the Zhengzhou University review board.

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The authors declare no competing interests

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Responsible Editor: Lotfi Aleya

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Jiang, J., Chen, G., Li, B. et al. Associations of residential greenness with hypertension and blood pressure in a Chinese rural population: a cross-sectional study. Environ Sci Pollut Res 28, 51693–51701 (2021). https://doi.org/10.1007/s11356-021-14201-0

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  • DOI: https://doi.org/10.1007/s11356-021-14201-0

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