Living green areas and risk of cardiovascular diseases

Bezug Yeager, R., Riggs, D., DeJarnett, N., et al. Assoziation zwischen Wohnbegrünung und Risiko für Herz-Kreislauf-Erkrankungen. J Am Heart Assoc. 2018;7(e009117). Studienziel Bewertung der Auswirkungen von Grünflächen in Wohngebieten auf Marker für Herz-Kreislauf-Erkrankungen (CVD) Design & Teilnehmer Dies war eine Querschnittsstudie mit 408 Teilnehmern (48 % weiblich, Durchschnittsalter 51,4 ± 10,8 Jahre), die zwischen 2009 und 2014 Patienten an der ambulanten kardiovaskulären Klinik der Universität von Louisville waren. Alle Teilnehmer wurden aufgrund eines leichten bis mittelschweren kardiovaskulären Risikos rekrutiert Faktoren (z. B. mittlerer BMI 32,9, mittlerer Blutdruck 131/80) und/oder frühere kardiale Ereignisse in der Anamnese. Zielparameter Die Wohnadressen der Teilnehmer …
Reference Yeager, R., Riggs, D., Dejarnett, N., et al. Association between greening and risk for cardiovascular diseases. J am Heart Assoc. 2018; 7 (E009117). Study goal Evaluation of the effects of green spaces in residential areas on markers on cardiovascular diseases (CVD) Design & participants This was a cross-sectional study with 408 participants (48 % female, average age 51.4 ± 10.8 years), who were patients at the outpatient cardiovascular clinic of the University of Louisville between 2009 and 2014. All participants were recruited due to a slight to moderate cardiovascular risk (e.g. medium BMI 32.9, medium blood pressure 131/80) and/or earlier cardiac events in the anamnesis. Target parameters The residential addresses of the participants ... (Symbolbild/natur.wiki)

Living green areas and risk of cardiovascular diseases

reference

Yeager, R., Riggs, D., Dejarnett, N., et al. Association between greening and risk for cardiovascular diseases. j am Heart Assoc . 2018; 7 (E009117).

Study goal

Assessment of the effects of green spaces in residential areas on markers for cardiovascular diseases (CVD)

Design & participants

This was a cross -sectional study with 408 participants (48 % female, average age 51.4 ± 10.8 years), who were patients at the outpatient cardiovascular clinic of the University of Louisville between 2009 and 2014. All participants were recruited due to a slight to moderate cardiovascular risk (e.g. medium BMI 32.9, medium blood pressure 131/80) and/or earlier cardiac events in the medical history.

target parameter

The residential addresses of the participants were mapped using the Geographic Information System (GIS) software and spatially correlated with the current satellite data of the Normalized Difference Vegetation Index (NDVI) in order to evaluate the relative amount of the surrounding green areas in circles with a radius of 250 m and 1 km. (Dense forests).

urine and blood biomark data was collected by each participant in order to evaluate the current cardiovascular risk, damage and/or repairs as follows:

  • Cardiovascular risk: adrenaline, noradrenaline, dopamine, serotonin, standardetane phrase, 3-method, metanephrin, 5-hydroxyindol-3-vicaric acid, homovanillic acid and vanillyl lamb Sympathetic neuroendocrine activation, which is known to contribute to cardiovascular diseases.
  • cardiovascular damage: F2 isoprostan in the urine, a marker for oxidative stress.
  • cardiovascular repair: lower types 1-15 of the serum circulating angiogenic cells (CAC), which reflect the new growth of the vessels after damage.

All samples were collected between 1:00 p.m. and 4:00 p.m. to minimize circadian fluctuations. Urine samples were standardized on creatinine levels.

The patient biomarker and NDVI data were analyzed with the spatial correlation software GIS. All results were adapted by several demographic, clinical, residential and environmental factors, including age, gender, ethnicity, smoking status, BMI, statin consumption, medium household income, area privation index, road density within 50 m around the place of residence and concentration of PM2.5 (fine dust <2.5 micrometer) Air pollution outside the house for all statistical Models.

important knowledge

After cleanup To allocate all measured factors, the data show a significant reverse association of living green areas with all biomarker categories, including the following:

  • Acceptance of the epinephrinkon concentration in urine with increasing greening of living (−6.9 % per δ 0.1 ndvi; 95 % KI: −11.5 % to −2.0 %, p = 0.006) within 250 m, with statistical significance at 1 km.
  • Acceptance of the F2 Isoprostan concentration in the urine with increasing greening of living (−9.0 % per δ 0.1 NDVI; 95 % KI: −15.1 % to −2.5 %, p = 0.007) at 250 m, with statistical significance at 1 km.
  • Acceptance of relevant CAC concentrations in the serum with increasing green space within 250 m (effect sizes between –8.0 % and –15.6 %) and 1 km (effect sizes between –6.9 % and -10.1 %).

The data showed even more pronounced associations for certain groups, including women, participants who do not take any beta blockers, and participants without a prehistory of an earlier myocardial infarction.

practice implications

This study is published in magazine of the American Heart Association and demonstrates the increasing interest of the conventional medical system in the United States in the subjects of nature and health. Disciplines such as urban planning, public health or parks and relaxation have been researching the beneficial effects of green spaces for many years. It is nice to see that more medical journals are interested in this topic.

The results of the current study that is currently being checked should not be surprised. Empirical studies have been reporting on positive effects of exposure to green spaces for many decades. 1 One of the first of these studies, published in The Lanzette more than a decade ago showed a significant reduction in cardiovascular mortality in people who are surrounded by larger green areas, whereby the entire data set of the British National Health Service of 41 million people were used. 2 Other studies have shown similar associations of green spaces with coronary heart disease and stroke.

As suggested by the biomarkers used in this study, the proposed primary mechanism of action is the modulation of the psychophysiological stress response with the resulting effects on physical and mental health. This is sometimes referred to as "allostatic load". 5.6 Numerous recent research has shown the relationship between environmental factors in the neighborhood and the increase in allostatic stress. 7.8 and decades of research have researched acute exposure to green areas for stress. This current study is one of the first to use neuroendocrine and vascular repair biomarkers in a green space study in residential areas and thus expand the evidence for an action mechanism of the epidemiological cardiovascular results mentioned above, which is based on the reduction of psychophysiological stress and all-east stress.

restrictions

As a cross-sectional study, the data can only show associations between living green areas and CVD biomarkers. There cannot be any causality, and since the participants were not asked how much time they have spent at their place of residence, they may not reflect exactly how the duration of the exposure to green areas influences these biomarker results.

of greater interest is why Epinephrin is the only neuroendocrine biomarker in the urine (tested by the 10) who showed an association. When living green areas have an impact on psychophysiological function, as other studies have reported, why don't these other biomarkers reflect these changes? It may be that fluctuations in these markers are too temporary to measure basic line effects from chronic domestic exposure, in this case other markers such as cortisol could be more suitable. Other studies have examined this approach with positive results.

This study is published in magazine of the American Heart Association and demonstrates the increasing interest of the conventional medical system in the United States in the subjects of nature and health.

In addition, it is interesting that a study on measuring the cardiovascular risk did not use more conventional cardiovascular biomarkers such as the highly sensitive C reactive protein (HS-CRP) or fibrinogen if such markers are known to react to psychophysiological stress. All risk biomarkers in this study were collected through a urine sample, but blood was taken from each participant in order to record the vascular repair capacity through the CAC count, so that the collection of HS-CRP or fibrinogen was possible. It may be that these latter markers reflect an inflammatory immunological activity than neuroendocrine stress. Regardless of this, future studies may want to expand their collection of various biomarkers in order to enable a more robust examination of potential mechanisms.

conclusions

cardiovascular diseases are still one of the main causes of morbidity and mortality. There are indications that environmental factors such as the closeness and exposure to relaxing green spaces have stimulating, oxidative and repair mechanisms that affect cardiovascular health. It can be clinically and economically advantageous to support care and access to these green areas as part of a holistic, preventive approach to reduce the disease burden.

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