Tracking Restoration of Park and Urban Street Settings in Coronary Artery Disease Patients.
The physiological effects of natural and urban environments on the cardiovascular system of coronary artery disease (CAD) patients are not fully understood. This controlled field study examines the effects of restorative walking in a park vs. in an urban street environment on CAD patients' stress parameters and cardiac function.



Twenty stable CAD patients were randomly allocated to 7 days controlled walking in a city park or in an urban street environment group. The relationship between different environmental exposures and health effects was analyzed using Wilcoxon signed-rank test and exact Mann-Whitney U test.



The mean reduction in cortisol levels and negative effects after the walk on the first day was greater in the city park than in the urban street exposed group, while a reduction in negative effects in the urban group were greater after seven days. The reduction in diastolic blood pressure (DBP) in the park group was evident on the seventh day before the walk (-4 mm Hg, p = 0.031) and 60 min after the walk (-6.00 mm Hg, p = 0.002). The cortisol slope was negatively associated with the DBP changes (r = -0.514, p < 0.05).



Physical activity in a green environment with noise and air pollution levels lower than in an urban environment has a greater positive effect on CAD patients' stress level and hemodynamic parameters. Mitigating green environmental influences may allow urban residents to maintain health and reduce disability.
Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania. r.grazuleviciene@gmf.vdu.lt.
Regina
R
Grazuleviciene
Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania. j.vencloviene@gmf.vdu.lt.
Jone
J
Vencloviene
Department of Cardiology, Medical Academy, Lietuvos Sveikatos Mokslu Universitetas, Eivenių 2, Kaunas 50161, Lithuania. raimondas@efarmacija.lt.
Raimondas
R
Kubilius
Institute of Cardiology, Medical Academy, Lietuvos Sveikatos Mokslu Universitetas, Kaunas 50161, Lithuania. vytautasgri@gmail.com.
Vytautas
V
Grizas
Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania. a.danileviciute@gmf.vdu.lt.
Asta
A
Danileviciute
Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania. a.dedele@gmf.vdu.lt.
Audrius
A
Dedele
Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania. s.andrusaityte@gmf.vdu.lt.
Sandra
S
Andrusaityte
Department of Laboratory Medicine, Medical Academy, Lietuvos Sveikatos Mokslu Universitetas, Eiveniu Str. 2, Kaunas 50028, Lithuania. astra.vitkauskiene@kaunoklinikos.lt.
Astra
A
Vitkauskiene
Department of Laboratory Medicine, Medical Academy, Lietuvos Sveikatos Mokslu Universitetas, Eiveniu Str. 2, Kaunas 50028, Lithuania. rasastepkons@gmail.com.
Rasa
R
Steponaviciute
Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, Barcelona 08003, Spain. mnieuwenhuijsen@creal.cat.
Mark J
MJ
Nieuwenhuijsen
D000368:Aged; D002947:Cities; D003324:Coronary Artery Disease; D004779:Environment Design; D004781:Environmental Exposure / Q000009:adverse effects; D015444:Exercise; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D000068316:Parks, Recreational; D014506:Urban Renewal; D016138:Walking / Q000502:physiology
D006854:Hydrocortisone
cardiovascular disease; cortisol; green space; hemodynamic parameters; physical activity; urban environment