ArticleJournal of the American Heart Association2019
Association Between Neighborhood Walkability and Predicted 10-Year Cardiovascular Disease Risk: The CANHEART (Cardiovascular Health in Ambulatory Care Research Team) Cohort.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review.Journal of urban health : bulletin of the New York Academy of Medicine · 2023Pooled it
- Multi-use physical activity trails in an urban setting and cardiovascular disease: a difference-in-differences analysis of a natural experiment in Winnipeg, Manitoba, Canada.The international journal of behavioral nutrition and physical activity · 2022Trial
- The Association between Neighborhood Walkability and Physical Activity in a Behavioral Weight Loss Trial Testing the Addition of Remotely Delivered Feedback Messages to Self-Monitoring.Behavioral medicine (Washington, D.C.)Trial
- The relative importance of neighborhood environment features in explaining preeclampsia risk using machine learning.Pregnancy (Hoboken, N.J.) · 2026Article
- Observed and perceived walkability among young adults in San Francisco: spatial divergence, neighborhood inequality, and self-rated health.Cities & health · 2026Article
- The environmental exposome in heart failure risk and progression.Nature reviews. Cardiology · 2026Review
- Association of Park Size, Access and Neighbourhood Walkability with Physical Activity and Obesity: A Cross-Sectional Analysis.International journal of environmental research and public health · 2026Article
- Residential green space, walkability, and cardiometabolic biomarkers in midlife women: a longitudinal cohort study.Environmental research, health : ERH · 2026Article
- An evaluation of the impact of visual attributes of park landscape spaces on the emotional benefits and behavioral intention of younger older adults.Scientific reports · 2026Article
- Using Health Information Systems to Support Behavioral Interventions in Local Contexts: Scoping Review.JMIR medical informatics · 2026Review
- How does high-density built-environment affect the incidence of gestational diabetes mellitus.iScience · 2026Article
- Association between walkability and diverse health metrics: moderating role of social vulnerability.Journal of healthy eating and active living · 2026Article
- Associations between social and built environments and cardiovascular disease mortality across 342 Latin American cities: results from the SALURBAL study.Journal of global health · 2025Article
- Community-Level Compact City Design, Health Care Provision, and Outcomes of Patients With Stroke.Journal of the American Heart Association · 2025Article
- Cross-Sectional and Longitudinal Associations of Neighborhood Disadvantage With Fluid Biomarkers of Neuroinflammation and Neurodegeneration.Neurology · 2025Article
- Marginalized Neighborhoods and Health Outcomes in Younger Myocardial Infarction Survivors.JAMA network open · 2025Article
- Pavements to Longevity: The Influence of Neighborhood Walkability on Mortality in Taiwan.Environmental health perspectives · 2025Article
- Long-term effects of urban renewal on health and health inequalities: the Neighbourhoods Law in Barcelona, Spain.Journal of epidemiology and community health · 2025Article
- Impacts of imageability of architecture on brain health: A systematic literature review.Landscape and urban planning · 2025Article
- Association of perioperative step count tracked by a wristband with surgical outcomes in minimally invasive lung cancer surgery: a prospective observational study.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Individuals living in unwalkable neighborhoods appear to be less physically active and more likely to develop obesity, diabetes mellitus, and hypertension. It is unclear whether neighborhood walkability is a risk factor for future cardiovascular disease. Methods and Results We studied residents living in major urban centers in Ontario, Canada on January 1, 2008, using linked electronic medical record and administrative health data from the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) cohort. Walkability was assessed using a validated index based on population and residential density, street connectivity, and the number of walkable destinations in each neighborhood, divided into quintiles (Q). The primary outcome was a predicted 10-year cardiovascular disease risk of ≥7.5% (recommended threshold for statin use) assessed by the American College of Cardiology/American Heart Association Pooled Cohort Equation. Adjusted associations were estimated using logistic regression models. Secondary outcomes included measured systolic blood pressure, total and high-density lipoprotein cholesterol levels, prior diabetes mellitus diagnosis, and current smoking status. In total, 44 448 individuals were included in our analyses. Fully adjusted analyses found a nonlinear relationship between walkability and predicted 10-year cardiovascular disease risk (least [Q1] versus most [Q5] walkable neighborhood: odds ratio =1.09, 95% CI: 0.98, 1.22), with the greatest difference between Q3 and Q5 (odds ratio=1.33, 95% CI: 1.23, 1.45). Dose-response associations were observed for systolic blood pressure, high-density lipoprotein cholesterol, and diabetes mellitus risk, while an inverse association was observed with smoking status. Conclusions In our setting, adults living in less walkable neighborhoods had a higher predicted 10-year cardiovascular disease risk than those living in highly walkable areas.
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