Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China.
Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, United Kingdom.
Environ Int. 2022 Jan;158:106960. doi: 10.1016/j.envint.2021.106960. Epub 2021 Oct 30.
Arterial stiffness is a key non-invasive marker of early vascular ageing, however, little is known of its associations with urban built environment. We examined the associations of objectively-measured residential walkability and greenness with arterial stiffness in a large UK-wide population cohort.
We employed data from the baseline UK Biobank cohort comprising adult participants recruited over the period of 2006 to 2010. Residential walkability index, defined as a function of density (residential, retail and public transit), street-level design, and destination accessibility was measured using a 1-Km dwelling catchment, while greenness was modelled as the mean Normalized Difference Vegetation Index (NDVI) of 0.5-metre resolution assessed within a 0.5-Km catchment. Arterial stiffness index (ASI) was measured non-invasively from the pulse waveform. Linear regression models were developed to examine associations of walkability and greenness with arterial stiffness. Restricted cubic spline (RCS) models were developed to examine dose-response relationships. We also examined effect modifications by sex and age, as well as the interaction effect of greenness and walkability.
This cross-sectional study used a target sample of 169,704 UK Biobank participants aged ≥ 39 years. After full adjustments, in reference to the lowest walkability exposure quartile, those in the highest were associated with lower ASI (β = -0.083 m/s, 95% CI: -0.14 to -0.03, p = 0.005). Participants in the third and fourth NDVI greenness exposure quartiles were also associated with lower ASI (β = -0.074 m/s, -0.14 to -0.01, p < 0.020 for the third and β = -0.293 m/s, -0.36 to -0.23, p < 0.001 for the fourth quartiles in reference to the first). The inverse association between NDVI greenness and ASI was more pronounced among women (p < 0.001), older adults (p = 0.011) and among participants in the highest walkability quartile (p < 0.001).
Designing more walkable and greener residential environments can be a preventive intervention aimed at lowering the population distribution of vascular ageing and associated cardiovascular risks.
动脉僵硬度是早期血管老化的一个关键的非侵入性指标，但人们对其与城市建成环境的关系知之甚少。我们研究了在一个大型的英国人群队列中，通过客观测量的居住可步行性和绿化与动脉僵硬度的关联。
我们使用了 2006 年至 2010 年期间招募的 UK Biobank 队列的基线数据。居住可步行性指数定义为密度（住宅、零售和公共交通）、街道层面设计和目的地可达性的函数，使用 1 公里的居住集水区进行测量，而绿化则作为 0.5 米分辨率内的归一化差异植被指数（NDVI）的平均值建模，集水区为 0.5 公里。通过脉搏波无创地测量动脉僵硬度指数（ASI）。使用线性回归模型来研究步行能力和绿化与动脉僵硬度的关联。采用限制性三次样条（RCS）模型来研究剂量-反应关系。我们还研究了性别和年龄的效应修饰作用，以及绿化和步行能力的交互作用。
本横断面研究使用了年龄≥39 岁的 169704 名 UK Biobank 参与者的目标样本。经过全面调整后，与最低步行能力暴露四分位相比，最高步行能力暴露四分位者的 ASI 较低（β=-0.083m/s，95%CI：-0.14 至 -0.03，p=0.005）。第三和第四 NDVI 绿化暴露四分位的参与者的 ASI 也较低（β=-0.074m/s，-0.14 至 -0.01，p<0.020 第三四分位，β=-0.293m/s，-0.36 至 -0.23，p<0.001 第四四分位，与第一四分位相比）。NDVI 绿化与 ASI 之间的反比关系在女性（p<0.001）、老年人（p=0.011）和步行能力最高四分位的参与者中更为明显（p<0.001）。
设计更适合步行和绿化的居住环境可能是一种预防干预措施，旨在降低人口分布中的血管老化和相关心血管风险。
