Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study.
Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study.
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DOI：
10.1186/1476-069x-13-20
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发表时间：
2014-03-19
期刊：
影响因子：
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通讯作者：
Nieuwenhuijsen MJ
中科院分区：
文献类型：
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作者：
Tamosiunas A;Grazuleviciene R;Luksiene D;Dedele A;Reklaitiene R;Baceviciene M;Vencloviene J;Bernotiene G;Radisauskas R;Malinauskiene V;Milinaviciene E;Bobak M;Peasey A;Nieuwenhuijsen MJ
本研究的目的是探讨城市绿地的距离和使用与心血管疾病（CVD）患病率及其危险因素的关系，并评估绿地的可及性和使用对立陶宛考纳斯市人口心血管疾病发病率的影响。我们介绍了一项考纳斯队列研究的结果，该研究涉及绿地的获取和使用，与心血管危险因素和其他健康相关变量的关联，以及心血管死亡率和发病率的风险。在2006-2008年期间，对5112名年龄在45-72岁之间的人进行了随机抽样。在平均4.41年的随访期间，基线调查时无冠心病和卒中的人中有83人死于心血管疾病，364人死于非致死性心血管疾病。采用多变量Cox比例风险回归模型进行数据分析。我们发现，人们住所到绿地的距离与健康相关变量的流行率无关。然而，使用公园者的心血管危险因素患病率和糖尿病患病率明显低于不使用公园者。在随访期间，与距离绿地347.8米或更短（1分位数）的男性和女性相比，居住距离绿地≥629.61米（距绿地距离的第3分位数）的人群（风险比(HR) = 1.36）罹患非致命性心血管疾病的风险增加。居住距离绿地≥347.81米（第2和第3分位数）且不使用公园的人群（HR = 1.66）罹患非致命性心血管疾病的风险增加。居住在远离公园的男性（第3分之一）与居住在附近的男性（第1分之一）相比，非致命性和致命性心血管疾病合并的风险更高（HR = 1.51）。与住在附近的公园使用者（第一分位）相比，非公园使用者和住在离公园较远的女性（第二和第三分位）的非致命性心血管疾病风险显著增加（HR = 2.78）。我们的分析表明，旨在促进城市环境中健康生活方式的公共卫生政策可能对心血管有益。
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). 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. 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). Our analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.