Association of Neighborhood Characteristics With Cardiovascular Health in the Multi-Ethnic Study of Atherosclerosis
Association of Neighborhood Characteristics With Cardiovascular Health in the Multi-Ethnic Study of Atherosclerosis
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DOI：
10.1161/circoutcomes.113.000698
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发表时间：
2014-07-01
影响因子：
6.9
通讯作者：
Allen, Norrina B.
中科院分区：
文献类型：
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作者：
Unger, Erin;Diez-Roux, Ana V.;Allen, Norrina B.
背景-心血管健康（CVH）的概念被引入作为一个全球性的衡量一个人的负担的心血管危险因素。以前的研究建立了邻里特征和个体心血管危险因素之间的关系。然而，邻里环境和整体CVH之间的关系仍然unknowed.Methods和结果，我们分析了多种族研究的动脉粥样硬化基线检查（2000 - 2002）的数据。平均年龄为61.6岁，52%为女性。根据美国心脏协会2020年战略目标定义了胆固醇、体重指数、饮食、体力活动、空腹血糖、血压和吸烟的理想、中等和较差类别，分配了一个单独的分数，并求和以创建一个总分数。CVH评分分为理想（11-14分）、中等（9-10分）和差（0-8分）。社区暴露包括有利的食品储存和体力活动资源密度（1英里缓冲区），报告的健康食品供应，步行/体力活动环境，安全性和社会凝聚力（人口普查区）。使用多项逻辑回归确定每个特征与理想和中间CVH的相关性，调整人口统计学和社区社会经济地位。超过20%的多种族动脉粥样硬化研究参与者在基线时具有理想的CVH评分。在充分调整的模式，有利的食品商店（优势比=1.22; 1.06-1.40），体力活动资源（比值比=1.19; 1.08-1.31），步行/体力活动环境（比值比=1.20; 1.05-1.37），和社区社会经济地位（优势比=1.22; 1.11-1.33）与具有理想CVH评分的较高几率相关。结论-邻里环境包括有利的食品商店，体育活动资源，步行/体育活动环境，和社区社会经济地位与理想的CVH相关。社区环境与CVH之间的纵向关系有待进一步研究。
Background-The concept of cardiovascular health (CVH) was introduced as a global measure of one's burden of cardiovsacular risk factors. Previous studies established the relationship between neighborhood characteristics and individual cardiovascular risk factors. However, the relationship between neighborhood environment and overall CVH remains unknown.Methods and Results-We analyzed data from the Multi-Ethnic Study of Atherosclerosis baseline examination (20002002). Mean age was 61.6 years, and 52% were women. Ideal, intermediate, and poor categories of cholesterol, body mass index, diet, physical activity, fasting glucose, blood pressure, and smoking were defined according to the American Heart Association 2020 Strategic Goals, assigned an individual score, and summed to create an overall score. CVH scores were categorized into ideal (11-14 points), intermediate (9-10), and poor (0-8). Neighborhood exposures included favorable food store and physical activity resources densities (by 1-mile buffer), reported healthy food availability, walking/physical activity environment, safety, and social cohesion (by census tract). Multinomial logistic regression was used to determine the association of each characteristic with ideal and intermediate CVH, adjusted for demographics and neighborhood socioeconomic status. Over 20% of Multi-Ethnic Study of Atherosclerosis participants had an ideal CVH score at baseline. In fully adjusted models, favorable food stores (odds ratio=1.22; 1.06-1.40), physical activity resources (odds ratio=1.19; 1.08-1.31), walking/physical activity environment (odds ratio=1.20; 1.05-1.37), and neighborhood socioeconomic status (odds ratio=1.22; 1.11-1.33) were associated with higher odds of having an ideal CVH score.Conclusions-Neighborhood environment including favorable food stores, physical activity resources, walking/physical activity environment, and neighborhood socioeconomic status are associated with ideal CVH. Further research is needed to investigate the longitudinal associations between neighborhood environment and CVH.