Associations of residential greenness with hypertension and blood pressure in a Chinese rural population: a cross-sectional study

Jie Jiang, Gongbo Chen, Baojing Li, Na Li, Feifei Liu, Yuanan Lu, Yuming Guo, Shanshan Li, Lifeng Chen, Hao Xiang

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Limited epidemiological literature identified the associations between residential greenness and hypertension in low-/middle-income countries. A random sampling strategy was adopted to recruit 39,259 residents, ≥ 18 years, and from 5 counties in central China. Blood pressure was measured based on the protocol of the American Heart Association. Hypertension was defined according to the 2010 Chinese guidelines for the management of hypertension. The satellite-derived normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were applied to estimate the residential greenness. Mixed logit model and mixed linear model were utilized to explore the relationships of residential greenness with hypertension and blood pressure. Higher residential greenness was associated with lower odds of hypertension and blood pressure levels. For instance, an interquartile range (IQR) increase in NDVI500m was linked with lower odds of hypertension (OR = 0.92, 95%CI 0.88 to 0.95), a decrease of −0.88 mm Hg (95% CI −1.17 to −0.58) and −0.64 mm Hg (95% CI −0.82 to −0.46) in SBP and DBP, respectively. The effect of residential greenness was more pronounced in males, smokers, and drinkers. Long-term exposure to residential greenness was linked with lower odds of hypertension. More prospective studies are needed to verify the hypothesis.

Original languageEnglish
Number of pages9
JournalEnvironmental Science and Pollution Research
Publication statusAccepted/In press - 2021


  • Blood pressure
  • Greenness
  • Hypertension
  • Rural population

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