Abstract 11545: Moving to a Highly Walkable Neighborhood and Incidence of Hypertension: A Propensity-score Matched Cohort Study

Abstract

Introduction: Despite growing interest in the built environment and its impact on cardiovascular health, little is known about whether moving to a neighborhood more conducive to walking influences one’s risk of hypertension, a key risk factor of cardiovascular diseases. Objective: To conduct the first cohort study examining the association between moving to a highly walkable neighborhood and the risk of incident hypertension among a population-based sample of adults in Ontario, Canada. Methods: From the Canadian Community Health Survey (2001-2010), we identified a propensity-score matched cohort of 1057 pairs of Canadian adults who moved from a low (Walk Score<90) walkability neighborhood to either a high (Walk Score≥90) or another low walkability neighborhood. The Walk Score (www.walkscore.com) is a walkability index shown to be valid in multiple geographic locations and at multiple spatial scales. The matched groups were well balanced on 16 important factors, including age, income, marital status and body-mass index. Incident hypertension was ascertained by linking the cohort to administrative health databases using a validated algorithm. Thyroid stimulating hormone testing and annual health examinations were used as the control events. Results: We observed a 42% lower risk of incident hypertension among those who moved from a low to high walkability neighborhood vs. those who moved from a low to another low walkability neighborhood (p=0.03) (Figure below). The incidence rate of hypertension was 8.6 per 1,000 person-years among the low to high walkability movers compared to 14.9 per 1,000 person-years among the low to low walkability movers. There were no significant differences in the control event rates between the two mover groups. Conclusions: Moving to a highly walkable neighborhood was associated with a significant protective effect on hypertension incidence, suggesting that the built environment can positively influence cardiovascular health.