Abstract
Evidence favoring a beneficial association between greenness and blood pressure (BP) in adults is accumulating. However, children and adolescents have been understudied accordingly. Methodologically, the data on “exposure” to residential green spaces are commonly satellite-derived, including rare existing studies on the relationship between proximity to green spaces and BP in children. Despite perfectly obliterating subjective biases, remote sensing methods of greenness data collection fail to address pragmatic interaction with such settings. This study aimed to assess the relationship between subjective proximity to green spaces and average/elevated BP in children. Through our study, systolic and diastolic BPs of 12,340 schoolchildren living in CASPIAN-V study areas were examined and recorded. We performed surveys to obtain the data on their proximity to green spaces, defined as having access to such spaces within a 15-minute walk from their homes. Linear mixed-effects models with BP as the outcome variable and the measure of exposure to green spaces as fixed-effect predictor were applied. The analysis was adjusted for several covariates. We found that perceived residential proximity to green spaces was associated with −0.08 mmHg (95% confidence intervals (CIs): −0.58, 0.41; p value = 0.72) reduction in systolic BP and −0.09 (95% CIs: −0.49, 0.31; p value = 0.66) reduction in diastolic BP. We also observed statistically nonsignificant odds ratio of 1.03 (95% CIs: 0.76, 1.39), 0.96 (95% CIs: 0.80, 1.16), and 0.98 (95% CIs: 0.82, 1.16) for isolated systolic/diastolic hypertension and hypertension, respectively. Our observations remained consistent after adjustment for height, parental employment, low birth weight, parental obesity, single parent, and breastfeeding. In conclusion, subjective proximity to green spaces might not be associated with a lower mean BP in children. Well-designed studies applying both subjective and objective data should be performed to elaborate on the relationship further.
Highlights
Over the past decades, the prevalence of noncommunicable diseases (NCDs) has risen strikingly, indicating an alarming worldwide epidemic [1]
Conducting this study, we aim to evaluate the association between subjective proximity to green spaces and blood pressure (BP) in children and adolescents
Perceived residential proximity to green spaces was associated with −0.08 mmHg (95% confidence intervals (CIs): −0.58, 0.41, p value 0.72) reduction in systolic BP (SBP) and −0.09 reduction in diastolic blood pressure (DBP); none of the associations was statistically significant
Summary
The prevalence of noncommunicable diseases (NCDs) has risen strikingly, indicating an alarming worldwide epidemic [1]. Accumulating evidence is shedding light on the tracks of NCDs and cardiovascular diseases in the preadulthood, highlighting the significance of early environmental exposures [2,3,4,5,6,7,8]. In addition to classically established risk factors for high BP and hypertension (HTN), the role of urban environmental exposures, namely, disposal to air and noise pollutions, has gained attention owing to the recent research studies [10,11,12,13,14,15]. Exposure to green environments may diminish the risk of high BP and HTN in adults, presumably through enhancing physical activity and alleviating stress as well as being subject to air/noise pollutants [16,17,18,19]
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