城市绿地的可达性与使用情况以及心血管健康：考纳斯队列研究的结果
Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study.
作者信息
Tamosiunas Abdonas, Grazuleviciene Regina, Luksiene Dalia, Dedele Audrius, Reklaitiene Regina, Baceviciene Migle, Vencloviene Jone, Bernotiene Gailute, Radisauskas Ricardas, Malinauskiene Vilija, Milinaviciene Egle, Bobak Martin, Peasey Anne, Nieuwenhuijsen Mark J
机构信息
Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania.
出版信息
Environ Health. 2014 Mar 19;13(1):20. doi: 10.1186/1476-069X-13-20.
BACKGROUND
The aims of this study were to explore associations of the distance and use of urban green spaces with the prevalence of cardiovascular diseases (CVD) and its risk factors, and to evaluate the impact of the accessibility and use of green spaces on the incidence of CVD among the population of Kaunas city (Lithuania).
METHODS
We present the results from a Kaunas cohort study on the access to and use of green spaces, the association with cardiovascular risk factors and other health-related variables, and the risk of cardiovascular mortality and morbidity. A random sample of 5,112 individuals aged 45-72 years was screened in 2006-2008. During the mean 4.41 years follow-up, there were 83 deaths from CVD and 364 non-fatal cases of CVD among persons free from CHD and stroke at the baseline survey. Multivariate Cox proportional hazards regression models were used for data analysis.
RESULTS
We found that the distance from people's residence to green spaces was not related to the prevalence of health-related variables. However, the prevalence of cardiovascular risk factors and the prevalence of diabetes mellitus were significantly lower among park users than among non-users. During the follow up, an increased risk of non-fatal and fatal CVD combined was observed for those who lived ≥629.61 m from green spaces (3rd tertile of distance to green space) (hazard ratio (HR) = 1.36), and the risk for non-fatal CVD-for those who lived ≥347.81 m (2nd and 3rd tertile) and were not park users (HR = 1.66) as compared to men and women who lived 347.8 m or less (1st tertile) from green space. Men living further away from parks (3rd tertile) had a higher risk of non-fatal and fatal CVD combined, compared to those living nearby (1st tertile) (HR = 1.51). Compared to park users living nearby (1st tertile), a statistically significantly increased risk of non-fatal CVD was observed for women who were not park users and living farther away from parks (2nd and 3rd tertile) (HR = 2.78).
CONCLUSION
Our analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.
背景
本研究旨在探讨城市绿地的距离和使用情况与心血管疾病（CVD）患病率及其危险因素之间的关联，并评估绿地的可达性和使用情况对考纳斯市（立陶宛）人群中心血管疾病发病率的影响。
方法
我们展示了考纳斯一项关于绿地可达性和使用情况、与心血管危险因素及其他健康相关变量的关联以及心血管疾病死亡率和发病率风险的队列研究结果。2006 - 2008年对5112名年龄在45 - 72岁的个体进行了随机抽样筛查。在平均4.41年的随访期间，基线调查时无冠心病和中风的人群中，有83例死于心血管疾病，364例非致命性心血管疾病病例。采用多变量Cox比例风险回归模型进行数据分析。
结果
我们发现人们住所到绿地的距离与健康相关变量的患病率无关。然而，公园使用者中心血管危险因素的患病率和糖尿病的患病率显著低于非使用者。在随访期间，居住距离绿地≥629.61米（到绿地距离的第三个三分位数）的人群中，非致命性和致命性心血管疾病合并风险增加（风险比（HR）= 1.36），对于居住距离≥347.81米（第二和第三个三分位数）且不是公园使用者的人群，与居住距离绿地347.8米或更近（第一个三分位数）的男性和女性相比，非致命性心血管疾病风险为（HR = 1.66）。居住距离公园较远（第三个三分位数）的男性，与居住在附近（第一个三分位数）的男性相比，非致命性和致命性心血管疾病合并风险更高（HR = 1.51）。与居住在附近（第一个三分位数）的公园使用者相比，不是公园使用者且居住距离公园较远（第二和第三个三分位数）的女性非致命性心血管疾病风险在统计学上显著增加（HR = 2.78）。
结论
我们的分析表明，旨在促进城市健康生活方式的公共卫生政策可能会带来心血管方面的益处。
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