Urban Environment and Health: A Cross-Sectional Study of the Influence of Environmental Quality and Physical Activity on Blood Pressure.

Few studies have examined the relation between urban built environment and the prevalence of hypertension. This cross-sectional study aimed at assessing the relationship between the environmental quality, physical activity, and stress on hypertension among citizens of Kaunas city, Lithuania. We conducted a survey of 1086 citizens residing in 11 districts to determine their perceptions of environmental quality, health behavior, and health indices. The independent variables included residential traffic flows, access to public transportation and green spaces. Dependent variables included physician-diagnosed hypertension, systolic and diastolic blood pressure, and stress level. We used multivariable logistic regression to assess the associations as odds ratios (OR). The environmental factors beneficially associated with meeting the physical activity recommendations were opportunities for walking to reach the city's green spaces and available relaxation areas. Residents of high noise level districts aged 45-64 years had a significantly higher OR of stress and a higher prevalence of hypertension when age, sex, education status, family status, and smoking were accounted for. However, meeting the physical activity recommendations had a beneficial effect on the risk of hypertension. This study provided evidence that improvement of the district-level built environment supporting citizens' physical activity might reduce the risk of hypertension.

Environmental Quality Perceptions and Health: A Cross-Sectional Study of Citizens of Kaunas, Lithuania.

The perception of urban environmental quality is an important contributor when identifying local problems in sustainable development and environmental planning policy. This study examined the associations between environmental and social residential characteristics, physical activity, obesity, and hypertension in Kaunas city, Lithuania. This cross-sectional study analyzed 580 citizens' demographic-, socioeconomic-, health-, and lifestyle-related factors, environmental health concerns, and environmental quality perceptions. Using Geographic Information Systems and the multivariate logistic regression, we found that the less physically active group more often presented lower than mean ratings of the quality of pathways and cycling routes (32.9% and 45.6%, p = 0.042) and only irregularly visited the natural environment. Obese participants presented poorer ratings of air pollution, the quality of pathways and cycling routes, their possibility to reach green spaces by walking, and the available relaxing areas. The environmental issues associated with hypertension were poor possibilities to reach green spaces by walking (OR 1.94, 95% CI 1.14-3.32) and the availability of relaxation areas (OR 2.30, 95% 1.34-3.95). The quality of the neighborhood and individual-level characteristics were the factors that influenced a higher prevalence of health problems at the district level. Our findings suggest that a public health policy to improve the physical and social environment of the neighborhood would have a potential to increase citizens' physical activity and health.

Risk of hypertension related to road traffic noise among reproductive-age women.

Chronic noise exposure is associated with adverse pathophysiological effects, which may contribute to the progression of hypertension. However, evidence supporting its effect on women is still inconsistent. The aim of the study was to examine the hypertension risk related to road traffic noise in residential settings in an urban community amongst reproductive-aged women. Cross-sectional study data including 3,121 pregnant women, 20-45 years old, and a geographic information system (GIS) to assess the average road noise (LAeq 24 hr) for every subject at the current residential address were used. Effects on physician-diagnosed hypertension were estimated by logistic regression with adjustments for age, social status, marital status, education, alcohol consumption, ethnic group, parity, body mass index, chronic disease, and exposure duration. The prevalence of hypertension amongst women aged 20-45 years in the lowest exposure category was 13.1% in comparison to 13.6% and 18.1% amongst those exposed to the medium and the highest exposure category, respectively. After making adjustments for the selected variables, no exposure effects [Odds ratio (OR) ≈ 1.0] were noted in the medium exposure category [51-60 dB(A)]. However, a slight increase was noted in the highest exposure category [≥61 dB(A)), OR 1.36; 95% CI 0.86-2.15]. The effect was more pronounced amongst women aged 30-45 years and a positive exposure-response relation was indicated for hypertension: An effect was seen at noise levels 51-60 dB(A) (OR = 1.03; 95% CI 0.72-1.49) and at >61 dB(A) (OR = 1.94, 95% CI 1.01-3.72). The present study shows some evidence for an association between the residential road traffic noise and hypertension amongst reproductive-aged women, and an exposure-response relationship.