Neighborhood Environments and Incident Hypertension in the Multi-Ethnic Study of Atherosclerosis
Neighborhood Environments and Incident Hypertension in the Multi-Ethnic Study of Atherosclerosis
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DOI：
10.1093/aje/kwv296
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发表时间：
2016-06-01
影响因子：
5
通讯作者：
Lisabeth, Lynda
中科院分区：
文献类型：
--
作者：
Kaiser, Paulina;Roux, Ana V. Diez;Lisabeth, Lynda
我们使用来自多种族动脉粥样硬化研究的数据，对美国6个地区的3382名成年人进行了为期10年的随访（2000-2011），研究了社区物理和社会环境与高血压发病率之间的关系。样本年龄45-84岁（平均59岁），基线时无临床心血管疾病和高血压。在参与者中，51%为女性，44%为白人，23%为西班牙裔，21%为黑人，13%为华裔美国人；39%的参与者在平均7.2年的随访期间患上了高血压。Cox模型用于估计时变累积平均邻里特征（基于调查的健康食品供应、步行环境、社会凝聚力、安全性以及基于地理信息系统的有利食品商店和娱乐资源密度）与高血压事件的关联。在对个体和社区水平协变量进行调整后，健康食品供应增加1个标准差与高血压发病率降低12%相关（风险比= 0.88,95%可信区间：0.82,0.95）。其他社区特征与高血压发病率无关。邻里食物环境与高血压风险有关。
We examined relationships between neighborhood physical and social environments and incidence of hypertension in a cohort of 3,382 adults at 6 sites in the United States over 10 years of follow-up (2000-2011), using data from the Multi-Ethnic Study of Atherosclerosis. The sample was aged 45-84 years (mean = 59 years) and free of clinical cardiovascular disease and hypertension at baseline. Of the participants, 51% were female, 44% white, 23% Hispanic, 21% black, and 13% Chinese-American; 39% of participants developed hypertension during an average of 7.2 years of follow-up. Cox models were used to estimate associations of time-varying cumulative average neighborhood features (survey-based healthy food availability, walking environment, social cohesion, safety, and geographic information system-based density of favorable food stores and recreational resources) with incident hypertension. After adjustment for individual and neighborhood-level covariates, a 1-standard-deviation increase in healthy food availability was associated with a 12% lower rate of hypertension (hazard ratio = 0.88, 95% confidence interval: 0.82, 0.95). Other neighborhood features were not related to incidence of hypertension. The neighborhood food environment is related to the risk of hypertension.