Abstract P101: Neighborhood Walkability and Risk of Hypertension

Abstract

Introduction: Over the past decade, studies on associations between built environments and health outcomes have exponentially increased, particularly regarding walkability. Some studies have shown associations between walkability and lower blood pressure, as well as other cardiometabolic risk factors. Objective: The purpose of this study was to investigate associations between objectively measured neighborhood walkability and incidence of hypertension in older adults in a national cohort study in the United States. Methods: Neighborhood walkability was measured by Walk Score, and scores were generated for participants in the Reasons for Geographical and Racial Differences in Stroke Study (REGARDS, n=30,172). Descriptive statistics were reported by the categories of Walk Score: Car-Dependent, Somewhat Walkable, Very Walkable, and Walker’s Paradise. Associations between walkability and blood pressure were tested both cross-sectionally and longitudinally. Covariates included age, race, sex, geographical region, income, education, health behaviors (i.e., smoking, alcohol use, exercise), and cardiovascular comorbidities (i.e., dyslipidemia, diabetes). Linear models tested associations between Walk Score and systolic and diastolic blood pressure. Logistic regression models tested associations between Walk Score and incident, prevalent, and treated hypertension. Results: In adjusted analyses, Walk Score category was not associated with incident hypertension in the entire cohort. However, among white participants, a higher Walk Score category was associated with a lower odds of incident hypertension. In secondary analyses, higher Walk Score category was associated with lower odds of treated hypertension (OR 0.87, 95% CI 0.78-0.97, p=0.03). Higher Walk Score was linearly associated with higher diastolic blood pressure cross-sectionally in black participants but not among the entire cohort (P-interaction=0.02). Conclusions: We found limited evidence that higher walkability was an important contributor to hypertension. Further studies are needed to understand the associations between walkability and cardiovascular health outcomes. A better understanding of the relationship between residential features and hypertension could potentially help redefine intervention strategies for cardiovascular disease risk reduction.