Cargando…
Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA
Greenness may impact blood pressure (BP), though evidence is limited among individuals with type 2 diabetes (T2D), for whom BP management is critical. We evaluated associations of residential greenness with BP among individuals with T2D in geographically diverse communities in Pennsylvania. To addre...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828293/ https://www.ncbi.nlm.nih.gov/pubmed/33450813 http://dx.doi.org/10.3390/ijerph18020614 |
_version_ | 1783640976296771584 |
---|---|
author | Poulsen, Melissa N. Schwartz, Brian S. Nordberg, Cara DeWalle, Joseph Pollak, Jonathan Imperatore, Giuseppina Mercado, Carla I. Siegel, Karen R. Hirsch, Annemarie G. |
author_facet | Poulsen, Melissa N. Schwartz, Brian S. Nordberg, Cara DeWalle, Joseph Pollak, Jonathan Imperatore, Giuseppina Mercado, Carla I. Siegel, Karen R. Hirsch, Annemarie G. |
author_sort | Poulsen, Melissa N. |
collection | PubMed |
description | Greenness may impact blood pressure (BP), though evidence is limited among individuals with type 2 diabetes (T2D), for whom BP management is critical. We evaluated associations of residential greenness with BP among individuals with T2D in geographically diverse communities in Pennsylvania. To address variation in greenness type, we evaluated modification of associations by percent forest. We obtained systolic (SBP) and diastolic (DBP) BP measurements from medical records of 9593 individuals following diabetes diagnosis. Proximate greenness was estimated within 1250-m buffers surrounding individuals’ residences using the normalized difference vegetation index (NDVI) prior to blood pressure measurement. Percent forest was calculated using the U.S. National Land Cover Database. Linear mixed models with robust standard errors accounted for spatial clustering; models were stratified by community type (townships/boroughs/cities). In townships, the greenest communities, an interquartile range increase in NDVI was associated with reductions in SBP of 0.87 mmHg (95% CI: −1.43, −0.30) and in DBP of 0.41 mmHg (95% CI: −0.78, −0.05). No significant associations were observed in boroughs or cities. Evidence for modification by percent forest was weak. Findings suggest a threshold effect whereby high greenness may be necessary to influence BP in this population and support a slight beneficial impact of greenness on cardiovascular disease risk. |
format | Online Article Text |
id | pubmed-7828293 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78282932021-01-25 Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA Poulsen, Melissa N. Schwartz, Brian S. Nordberg, Cara DeWalle, Joseph Pollak, Jonathan Imperatore, Giuseppina Mercado, Carla I. Siegel, Karen R. Hirsch, Annemarie G. Int J Environ Res Public Health Article Greenness may impact blood pressure (BP), though evidence is limited among individuals with type 2 diabetes (T2D), for whom BP management is critical. We evaluated associations of residential greenness with BP among individuals with T2D in geographically diverse communities in Pennsylvania. To address variation in greenness type, we evaluated modification of associations by percent forest. We obtained systolic (SBP) and diastolic (DBP) BP measurements from medical records of 9593 individuals following diabetes diagnosis. Proximate greenness was estimated within 1250-m buffers surrounding individuals’ residences using the normalized difference vegetation index (NDVI) prior to blood pressure measurement. Percent forest was calculated using the U.S. National Land Cover Database. Linear mixed models with robust standard errors accounted for spatial clustering; models were stratified by community type (townships/boroughs/cities). In townships, the greenest communities, an interquartile range increase in NDVI was associated with reductions in SBP of 0.87 mmHg (95% CI: −1.43, −0.30) and in DBP of 0.41 mmHg (95% CI: −0.78, −0.05). No significant associations were observed in boroughs or cities. Evidence for modification by percent forest was weak. Findings suggest a threshold effect whereby high greenness may be necessary to influence BP in this population and support a slight beneficial impact of greenness on cardiovascular disease risk. MDPI 2021-01-13 2021-01 /pmc/articles/PMC7828293/ /pubmed/33450813 http://dx.doi.org/10.3390/ijerph18020614 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Poulsen, Melissa N. Schwartz, Brian S. Nordberg, Cara DeWalle, Joseph Pollak, Jonathan Imperatore, Giuseppina Mercado, Carla I. Siegel, Karen R. Hirsch, Annemarie G. Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA |
title | Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA |
title_full | Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA |
title_fullStr | Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA |
title_full_unstemmed | Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA |
title_short | Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA |
title_sort | association of greenness with blood pressure among individuals with type 2 diabetes across rural to urban community types in pennsylvania, usa |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828293/ https://www.ncbi.nlm.nih.gov/pubmed/33450813 http://dx.doi.org/10.3390/ijerph18020614 |
work_keys_str_mv | AT poulsenmelissan associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT schwartzbrians associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT nordbergcara associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT dewallejoseph associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT pollakjonathan associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT imperatoregiuseppina associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT mercadocarlai associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT siegelkarenr associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa AT hirschannemarieg associationofgreennesswithbloodpressureamongindividualswithtype2diabetesacrossruraltourbancommunitytypesinpennsylvaniausa |