The Effect of Park and Urban Environments on Coronary Artery Disease Patients: A Randomized Trial.

Regina Grazuleviciene,Marc Jones,Christopher Gidlow,Mark J Nieuwenhuijsen,Audrius Dedele,Tomas Grazulevicius,Jone Vencloviene,Egle Tamuleviciute-Prasciene,Vytautas Grizas,Indre Ceponiene,Raimondas Kubilius

doi:10.1155/2015/403012

Abstract

Aim. To test the hypothesis that walking in a park has a greater positive effect on coronary artery disease (CAD) patients' hemodynamic parameters than walking in an urban environment. Methods. Twenty stable CAD patients were randomized into two groups: 30-minute walk on 7 consecutive days in either a city park or busy urban street. Wilcoxon signed-rank test was employed to study short-term (30 min) and cumulative changes (following 7 consecutive days of exposure) in resting hemodynamic parameters in different environments. Results. There were no statistically significant differences in the baseline and peak exercise systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), exercise duration, or HR recovery in urban versus park exposure groups. Seven days of walking slightly improved all hemodynamic parameters in both groups. Compared to baseline, the city park group exhibited statistically significantly greater reductions in HR and DBP and increases in exercise duration and HR recovery. The SBP and DBP changes in the urban exposed group were lower than in the park exposed group. Conclusions. Walking in a park had a greater positive effect on CAD patients' cardiac function than walking in an urban environment, suggesting that rehabilitation through walking in green environments after coronary events should be encouraged.

Highlights

There is some evidence that green environments are associated with better self-reported health [1], lower blood pressure [2], lower psychophysiological stress [3, 4], and lower mortality risks [5]
After seven days of exposure, we found a slight decrease in resting diastolic blood pressure (DBP) and heart rate (HR) before the exercise test and a decrease in resting HR three hours after the test in patients exposed to urban environment
Data showed that regular 30 min walks of moderate intensity in a park environment performed on 7 consecutive days led to greater favorable changes in resting systolic blood pressure (SBP) and DBP, improvements in exercise tolerance, and increases in exercise duration, compared with equivalent walks in an urban environment

Summary

Introduction

There is some evidence that green environments are associated with better self-reported health [1], lower blood pressure [2], lower psychophysiological stress [3, 4], and lower mortality risks [5]. The benefits of physical activity in green environments of CAD patients in terms of functional capacity are uncertain. The effects of physical training in patients after acute MI on hemodynamic parameters may occur through improved autonomic nervous system function: HR recovery, resting HR, and SBP [8, 14,15,16,17]. Regular walking has been shown to reduce anxiety and tension, improve cholesterol profile, and control blood pressure [18] and can help to lower SBP and DBP in hypertensive patients [19].

Methods

Results

Conclusion