de Zorzi Viviane Nogueira, de Paiva Neto Francisco Timbó, Hubbler Figueiró Thamara, Macedo Danielle de Amaral, Alves Lucas Gomes, Tozetto Willen Remon, d'Orsi Eleonora, Rech Cassiano Ricardo
Postgraduation Program in Physical Education, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - 88040-900, Florianópolis, Brazil.
Hospital Israelita Albert Einstein. Av. Albert Einstein, 627/701 - Morumbi, São Paulo SP, 05652-900, Brazil.
Prev Med Rep. 2024 Oct 18;47:102909. doi: 10.1016/j.pmedr.2024.102909. eCollection 2024 Nov.
Research suggests a link between the urban built environment and blood pressure, potentially mediated by physical activity. This study aims to investigate the relationship between perceived neighborhood characteristics and blood pressure in older adults, as well as the mediating role of walking in this relationship.
Data from the third wave of the EpiFloripa Aging Cohort Study in Florianopolis, Brazil (2017-2019; n = 1335) were used for this cross-sectional analysis. Blood pressure was measured using digital devices, and hypertension diagnosis relied on healthcare professionals' information. The neighborhood environment was assessed with the Abbreviated Neighborhood Environment Walkability Scale, while walking was evaluated with the International Physical Activity Questionnaire. Multilevel logistic regression analyzed the association between the neighborhood environment, blood pressure, and hypertension. Structural equation modeling assessed the mediation effect of walking.
Hypertension prevalence was 85.3 %, with 69.0 % having objectively measured elevated blood pressure. Results showed that older adults perceiving better infrastructure for physical activity (OR: 0.88; CI: 0.78-0.99), increased safety in their neighborhood (OR: 0.88; CI: 0.79-0.99), traffic security (OR: 0.88; CI: 0.78-0.99) and better overall perception of the environment (OR: 0.73; IC: 0.55-0.98) had a lower likelihood of self-reported hypertension. The association between self-reported hypertension and overall perception of the environment was partially explained by leisure-time walking (β = -0.01; p < 0.05).
Our findings suggest that public policies promoting the establishment of safe and supportive spaces for physical activity emerge as essential measures in the prevention and management of hypertension in older adults.
研究表明城市建成环境与血压之间存在联系，可能通过体育活动介导。本研究旨在调查老年人对邻里特征的感知与血压之间的关系，以及步行在这种关系中的中介作用。
本横断面分析使用了巴西弗洛里亚诺波利斯市EpiFloripa衰老队列研究第三波（2017 - 2019年；n = 1335）的数据。使用数字设备测量血压，高血压诊断依据医疗专业人员的信息。邻里环境用简化邻里环境步行能力量表进行评估，步行情况用国际体力活动问卷进行评估。多水平逻辑回归分析邻里环境、血压和高血压之间的关联。结构方程模型评估步行的中介作用。
高血压患病率为85.3%，其中69.0%经客观测量血压升高。结果显示，认为体育活动基础设施更好（比值比：0.88；可信区间：0.78 - 0.99）、邻里安全性增加（比值比：0.88；可信区间：0.79 - 0.99）、交通安全（比值比：0.88；可信区间：0.78 - 0.99）以及对环境总体感知更好（比值比：0.73；可信区间：0.55 - 0.98）的老年人自我报告患高血压的可能性较低。休闲步行部分解释了自我报告的高血压与环境总体感知之间的关联（β = -0.01；p < 0.05）。
我们的研究结果表明，促进建立安全且支持体育活动的空间的公共政策是预防和管理老年人高血压的重要措施。
