Department of Social and Preventive Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
J Hypertens. 2012 Jul;30(7):1336-46. doi: 10.1097/HJH.0b013e3283544863.
Studies of associations between neighborhood environments and blood pressure (BP) have relied on imprecise characterizations of neighborhoods. This study examines associations between SBP and DBP and a neighborhood typology based on numerous residential environment characteristics.
Data from the Residential Environment and Coronary Heart Disease Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Cluster analysis was applied to measures of the physical, services and social interactions aspects of neighborhoods. Six contrasting neighborhood types were identified and examined in relation to SBP and DBP using multivariable linear regression, adjusting for individual/neighborhood socioeconomic status and individual risk factors for hypertension.
The neighborhood typology included suburban to central urban neighborhood types with varying levels of adverse social conditions. SBP was 2-3 mmHg higher among participants residing in suburban neighborhood types and in the urban with low social standing neighborhood type, compared to residents of central urban with intermediate social standing neighborhoods (reference). The association between residing in urban low social standing neighborhoods and SBP remained after adjusting for individual/neighborhood socioeconomic status and individual risk factors for hypertension. Overall, an inverse association between DBP and level of urbanicity of the neighborhood was observed, even after adjustment for individual risk factors for hypertension.
Variations in BP were observed by levels of urbanicity and social conditions of residential neighborhoods, with different patterns for SBP and DBP. Population interventions to reduce hypertension targeted towards specific neighborhood types hold promise.
研究邻里环境与血压（BP）之间的关联依赖于对邻里环境的不精确描述。本研究检验了基于众多居住环境特征的邻里分类法与 SBP 和 DBP 之间的关联。
分析了 2007-2008 年招募的居住在巴黎大都市区、年龄在 30-79 岁的 7290 名参与者的居住环境与冠心病研究的数据。应用聚类分析对邻里的物理、服务和社会互动方面的指标进行分析。确定了六种具有不同不利社会条件的对比邻里类型，并使用多变量线性回归分析方法，根据个体/邻里社会经济地位和高血压个体危险因素，检验这些邻里类型与 SBP 和 DBP 的关系。
邻里分类包括从郊区到中心城市的邻里类型，具有不同程度的不利社会条件。与居住在中心城市中等社会地位社区的参与者相比，居住在郊区和社会地位较低的城市社区的参与者的 SBP 要高 2-3mmHg（参考）。调整个体/邻里社会经济地位和高血压个体危险因素后，居住在城市社会地位较低的社区与 SBP 之间的关联仍然存在。总的来说，即使在调整了高血压个体危险因素后，也观察到 DBP 与城市人口密度之间呈负相关。
观察到 BP 随居住邻里的城市化水平和社会条件的变化而变化，SBP 和 DBP 的模式不同。针对特定邻里类型的以人群为基础的高血压干预措施具有一定的前景。
