title: Moving to a Highly Walkable Neighborhood and Incidence of Hypertension: A Propensity-Score Matched Cohort Study.
abstract: The impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain.
  
  
  
  Our study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension.
  
  
  
  A population-based propensity-score matched cohort study design was used based on the Ontario population from the Canadian Community Health Survey (2001-2010). Participants were adults ≥ 20 years of age who moved from a low-walkability neighborhood (defined as any neighborhood with a Walk Score < 90) to either a high- (Walk Score ≥ 90) or another low-walkability neighborhood. The incidence of hypertension was assessed by linking the cohort to administrative health databases using a validated algorithm. Propensity-score matched Cox proportional hazard models were used. Annual health examination was used as a control event.
  
  
  
  Among the 1,057 propensity-score matched pairs there was a significantly lower risk of incident hypertension in the low to high vs. the low to low-walkability groups [hazard ratio = 0.46; 95% CI, 0.26, 0.81, p < 0.01]. The crude hypertension incidence rates were 18.0 per 1,000 person-years (95% CI: 11.6, 24.8) among the low- to low-walkability movers compared with 8.6 per 1,000 person-years (95% CI: 5.3, 12.7) among the low- to high-walkability movers (p < 0.001). There were no significant differences in the hazard of annual health examination between the two mover groups.
  
  
  
  Moving to a highly walkable neighborhood was associated with a significantly lower risk of incident hypertension. Future research should assess whether specific attributes of walkable neighborhoods (e.g., amenities, density, land-use mix) may be driving this relationship.
  
  
  
  Chiu M, Rezai MR, Maclagan LC, Austin PC, Shah BR, Redelmeier DA, Tu JV. 2016. Moving to a highly walkable neighborhood and incidence of hypertension: a propensity-score matched cohort study. Environ Health Perspect 124:754-760; http://dx.doi.org/10.1289/ehp.1510425.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Chiu
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Rezai
authors.forename: Laura C
authors.initials: LC
authors.lastname: Maclagan
authors.forename: Peter C
authors.initials: PC
authors.lastname: Austin
authors.forename: Baiju R
authors.initials: BR
authors.lastname: Shah
authors.forename: Donald A
authors.initials: DA
authors.lastname: Redelmeier
authors.forename: Jack V
authors.initials: JV
authors.lastname: Tu
mesh_terms: D015331:Cohort Studies; D004779:Environment Design; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D009864:Ontario / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016138:Walking