TY - JOUR
T1 - Urban greenspaces and child blood pressure in China
T2 - Evidence from a large population-based cohort study
AU - Bao, Wen Wen
AU - Jiang, Nan
AU - Zhao, Yu
AU - Yang, Boyi
AU - Chen, Gongbo
AU - Pu, Yinqi
AU - Ma, Hanping
AU - Liang, Jinghong
AU - Xiao, Xiang
AU - Guo, Yuming
AU - Dong, Guanghui
AU - Chen, Yajun
N1 - The project was supported by grants from the Science and Technology Planning Project of Guangdong Province, China (No. 2014A020220002 and No. 2016A020225002), and the National Natural Science Foundation of China (No. 81673193 and No. 82273650).
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2024/3/1
Y1 - 2024/3/1
N2 - Background: With the world's population steadily shifting toward urban living, children's engagement with the natural environment seems to be diminishing. This raises significant concerns about the influence of urban greenspaces on the cardiovascular health of children. Objective: To assess the association between urban greenspaces exposure and blood pressure (BP) in Chinese primary schoolchildren. Methods: This prospective cohort study used data from the Children's growth environment, lifestyle, physical, and mental health development (COHERENCE) project in Guangzhou, China. Participants included 164,853 primary schoolchildren starting from 2016/17 to 2019/20 academic year. We assessed the surrounding greenspaces at home and school by using Sentinel-2 satellite data on the normalized difference vegetation index. Prehypertension and hypertension status were defined with BP above 90th to less than the 95th percentile, at or above the 95th percentile, respectively. The association of surrounding greenness with children's BP levels and risk of prehypertension/hypertension were examined using linear mixed-effects models and Cox proportional hazards model. Results: Among 164,853 eligible children aged 7.21 (0.74) years, 89,190 (54.1%) were boys. Our results showed that average systolic and diastolic BP increased by 0.48 and 0.42 standard deviations, respectively, over the 3-year follow-up. We identified 23,225 new cases of prehypertension and 35,067 of hypertension status. An interquartile range increase both in home-, school- and home-school NDVI100m was significantly associated with a reduction of 0.018–0.037 in BP z-scores and a 2.7%–7.6% lower risk of hypertension. Additionally, family socioeconomic status modified the impact of home-school greenness on BP levels. Air pollution exhibited mediating effects solely in school-greenness-BP associations, while physical activity and children's BMI mainly mediated the relationships between home-greenness and BP. Conclusion: The findings of this large cohort study suggest that surrounding greenspaces are associated with lower BP levels and a decreased risk of prehypertension and hypertension in Chinese schoolchildren.
AB - Background: With the world's population steadily shifting toward urban living, children's engagement with the natural environment seems to be diminishing. This raises significant concerns about the influence of urban greenspaces on the cardiovascular health of children. Objective: To assess the association between urban greenspaces exposure and blood pressure (BP) in Chinese primary schoolchildren. Methods: This prospective cohort study used data from the Children's growth environment, lifestyle, physical, and mental health development (COHERENCE) project in Guangzhou, China. Participants included 164,853 primary schoolchildren starting from 2016/17 to 2019/20 academic year. We assessed the surrounding greenspaces at home and school by using Sentinel-2 satellite data on the normalized difference vegetation index. Prehypertension and hypertension status were defined with BP above 90th to less than the 95th percentile, at or above the 95th percentile, respectively. The association of surrounding greenness with children's BP levels and risk of prehypertension/hypertension were examined using linear mixed-effects models and Cox proportional hazards model. Results: Among 164,853 eligible children aged 7.21 (0.74) years, 89,190 (54.1%) were boys. Our results showed that average systolic and diastolic BP increased by 0.48 and 0.42 standard deviations, respectively, over the 3-year follow-up. We identified 23,225 new cases of prehypertension and 35,067 of hypertension status. An interquartile range increase both in home-, school- and home-school NDVI100m was significantly associated with a reduction of 0.018–0.037 in BP z-scores and a 2.7%–7.6% lower risk of hypertension. Additionally, family socioeconomic status modified the impact of home-school greenness on BP levels. Air pollution exhibited mediating effects solely in school-greenness-BP associations, while physical activity and children's BMI mainly mediated the relationships between home-greenness and BP. Conclusion: The findings of this large cohort study suggest that surrounding greenspaces are associated with lower BP levels and a decreased risk of prehypertension and hypertension in Chinese schoolchildren.
KW - Blood pressure
KW - Cardiovascular health
KW - Cohort study
KW - Greenspace
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=85179884434&partnerID=8YFLogxK
UR - https://www.sciencedirect.com/science/article/pii/S0013935123027470?via%3Dihub
U2 - 10.1016/j.envres.2023.117943
DO - 10.1016/j.envres.2023.117943
M3 - Journal article
C2 - 38104917
AN - SCOPUS:85179884434
SN - 0013-9351
VL - 244
JO - Environmental Research
JF - Environmental Research
M1 - 117943
ER -
