title: Neighborhood Environments and Incident Hypertension in the Multi-Ethnic Study of Atherosclerosis.
abstract: We examined relationships between neighborhood physical and social environments and incidence of hypertension in a cohort of 3,382 adults at 6 sites in the United States over 10 years of follow-up (2000-2011), using data from the Multi-Ethnic Study of Atherosclerosis. The sample was aged 45-84 years (mean = 59 years) and free of clinical cardiovascular disease and hypertension at baseline. Of the participants, 51% were female, 44% white, 23% Hispanic, 21% black, and 13% Chinese-American; 39% of participants developed hypertension during an average of 7.2 years of follow-up. Cox models were used to estimate associations of time-varying cumulative average neighborhood features (survey-based healthy food availability, walking environment, social cohesion, safety, and geographic information system-based density of favorable food stores and recreational resources) with incident hypertension. After adjustment for individual and neighborhood-level covariates, a 1-standard-deviation increase in healthy food availability was associated with a 12% lower rate of hypertension (hazard ratio = 0.88, 95% confidence interval: 0.82, 0.95). Other neighborhood features were not related to incidence of hypertension. The neighborhood food environment is related to the risk of hypertension.
authors.forename: Paulina
authors.initials: P
authors.lastname: Kaiser
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
authors.forename: Mahasin
authors.initials: M
authors.lastname: Mujahid
authors.forename: Mercedes
authors.initials: M
authors.lastname: Carnethon
authors.forename: Alain
authors.initials: A
authors.lastname: Bertoni
authors.forename: Sara D
authors.initials: SD
authors.lastname: Adar
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Robyn
authors.initials: R
authors.lastname: McClelland
authors.forename: Lynda
authors.initials: L
authors.lastname: Lisabeth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000208:ethnology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D044469:Racial Groups / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012449:Safety / Q000706:statistics & numerical data; D012931:Social Environment; D012959:Socioeconomic Factors; D000072264:Sports and Recreational Facilities / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D016138:Walking
keywords: hypertension; longitudinal studies; neighborhoods