title: The Effect of Park and Urban Environments on Coronary Artery Disease Patients: A Randomized Trial.
abstract: OBJECTIVE
  To test the hypothesis that walking in a park has a greater positive effect on coronary artery disease (CAD) patients' hemodynamic parameters than walking in an urban environment.
  
  
  METHODS
  Twenty stable CAD patients were randomized into two groups: 30-minute walk on 7 consecutive days in either a city park or busy urban street. Wilcoxon signed-rank test was employed to study short-term (30 min) and cumulative changes (following 7 consecutive days of exposure) in resting hemodynamic parameters in different environments.
  
  
  RESULTS
  There were no statistically significant differences in the baseline and peak exercise systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), exercise duration, or HR recovery in urban versus park exposure groups. Seven days of walking slightly improved all hemodynamic parameters in both groups. Compared to baseline, the city park group exhibited statistically significantly greater reductions in HR and DBP and increases in exercise duration and HR recovery. The SBP and DBP changes in the urban exposed group were lower than in the park exposed group.
  
  
  CONCLUSIONS
  Walking in a park had a greater positive effect on CAD patients' cardiac function than walking in an urban environment, suggesting that rehabilitation through walking in green environments after coronary events should be encouraged.
authors.affiliation: Department of Environmental Science, Vytautas Magnus University, K. Donelaicio 58, LT-44248 Kaunas, Lithuania.
authors.forename: Regina
authors.initials: R
authors.lastname: Grazuleviciene
authors.affiliation: Department of Environmental Science, Vytautas Magnus University, K. Donelaicio 58, LT-44248 Kaunas, Lithuania.
authors.forename: Jone
authors.initials: J
authors.lastname: Vencloviene
authors.affiliation: Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50167 Kaunas, Lithuania.
authors.forename: Raimondas
authors.initials: R
authors.lastname: Kubilius
authors.affiliation: Institute of Cardiology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50167 Kaunas, Lithuania.
authors.forename: Vytautas
authors.initials: V
authors.lastname: Grizas
authors.affiliation: Department of Environmental Science, Vytautas Magnus University, K. Donelaicio 58, LT-44248 Kaunas, Lithuania.
authors.forename: Audrius
authors.initials: A
authors.lastname: Dedele
authors.affiliation: Department of Environmental Science, Vytautas Magnus University, K. Donelaicio 58, LT-44248 Kaunas, Lithuania.
authors.forename: Tomas
authors.initials: T
authors.lastname: Grazulevicius
authors.affiliation: Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50167 Kaunas, Lithuania.
authors.forename: Indre
authors.initials: I
authors.lastname: Ceponiene
authors.affiliation: Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50167 Kaunas, Lithuania.
authors.forename: Egle
authors.initials: E
authors.lastname: Tamuleviciute-Prasciene
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.affiliation: Centre for Sport, Health and Exercise Research, Staffordshire University, Brindley Building, Leek Road, Stoke-on-Trent ST4 2DF, UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Jones
authors.affiliation: Centre for Sport, Health and Exercise Research, Staffordshire University, Brindley Building, Leek Road, Stoke-on-Trent ST4 2DF, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Gidlow
mesh_terms: D002947:Cities; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000534:rehabilitation; D015444:Exercise; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068316:Parks, Recreational