Evidence map›Paper›PMID 39047544›Full record

ArticleEnvironment international2024

The effect of residential greenness on cardiovascular mortality from a large cohort in South China: An in-depth analysis of effect modification by multiple demographic and lifestyle characteristics.

Xiaowen Wang, Yuqin Zhang, Benmarhnia Tarik, Kai Zhang, Shao Lin, Xinlei Deng, Haogao Gu, Wenjing Wu, Xiao Lin, Zhicheng Du and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Environment international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Xiaowen WangPeking University Center for Public Health and Epidemic Preparedness & Response, Peking University; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China.
Yuqin ZhangPeking University Center for Public Health and Epidemic Preparedness & Response, Peking University; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China; Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Benmarhnia TarikScripps Institution of Oceanography, University of California, San Diego, CA, USA; Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche En Santé, Environnement Et Travail) - UMR_S 1085, Rennes, France.
Kai ZhangDepartment of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
Shao LinDepartment of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
Xinlei DengEpidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
Haogao GuSchool of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Wenjing WuDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Xiao LinDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Zhicheng DuDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Ying WangDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Yanji QuGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China.
Ziqiang LinDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Man ZhangDepartment of Nosocomial Infection Management, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Yongqing SunDepartment of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
Guang-Hui DongDepartment of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Yongyue WeiPeking University Center for Public Health and Epidemic Preparedness & Response, Peking University; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China. Electronic address: ywei@bjmu.edu.cn.
Wangjian ZhangDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address: zhangwj227@mail.sysu.edu.cn.
Yuantao HaoPeking University Center for Public Health and Epidemic Preparedness & Response, Peking University; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China. Electronic address: haoyt@bjmu.edu.cn.

Funding

Intramural NIH HHS Z99 ES999999
6 · The paper itself

Abstract

backgroundThe potential for residential greenness to improve cardiovascular health through both physical and psychological mechanisms is well recognized. However, evidence from rapidly urbanizing developing countries and cohort-based causal inference approaches, remains limited. We aim to examine the effect of residential greenness and time to cardiovascular mortality in South China.

methodsWe utilized data from a community-based population survey involving 748,209 participants at baseline from 2009 to 2015, followed up until 2020. Residential greenness exposure was assessed by the annual Normalized Difference Vegetation Index (NDVI) in the 500 m radius of each participant's residence. We used time-varying proportional hazard Cox models coupled with inverse probability weighting to fit marginal structural models and obtain hazard ratios (HRs) for cardiovascular disease (CVD) mortality after adjusting for confounders. Multiple effect modifiers on both additive and multiplicative scales were further explored.

resultsA total of 15,139 CVD-related deaths were identified during a median of 7.9 years of follow-up. A protective effect was found between higher greenness exposure and reduced CVD mortality, with a 9.3 % lower rate of total CVD mortality (HR 0.907, 95 % CI 0.859-0.957) based on a 0.1 increase in annual average NDVI. Demographic (age, marital status) and lifestyle factors (smoking, drinking status) were found to modify the association between residential greenness and CVD mortality (all P interaction values < 0.05 or 95 %CI for RERI excluded the value 0). Notably, this effect was more pronounced among older adults, married, and individuals having healthier lifestyles, indicating a greater benefit from greenness for these subgroups.

conclusionsOur findings support a causal link between increased residential greenness exposure and a reduced risk of CVD mortality in South China with marked heterogenous effects, which has public health implications for cultivating greener urban environments to mitigate the impact of CVD within the context of rapid urbanization.

Indexed as

Cardiovascular DiseasesLife StyleAdultAgedChinaCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsResidence CharacteristicsRisk FactorsCardiovascular diseaseCausal inferenceCohortGreennessLifestyles Interaction

Identifiers

PMID39047544
PMCPMC12961614

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.