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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...

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Autores principales: Poulsen, Melissa N., Schwartz, Brian S., Nordberg, Cara, DeWalle, Joseph, Pollak, Jonathan, Imperatore, Giuseppina, Mercado, Carla I., Siegel, Karen R., Hirsch, Annemarie G.
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
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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.
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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
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