Impact of residential greenness on myocardial infarction in the population with diabetes: A sex-dependent association? Article Swipe
Anna Ponjoan
,
Jordi Blanch
,
Lia Alves‐Cabratosa
,
Ruth Martí‐Lluch
,
Marc Comas‐Cufí
,
Marta Cirach
,
Mark Nieuwenhuijsen
,
Maria García-Gil
,
Rafel Ramos
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1016/j.envres.2021.112449
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1016/j.envres.2021.112449
Living in urban areas with abundant greenness might provide health benefits in general population. Literature suggests that sex/gender plays a role in the association between greenness and health outcomes. But the impact of greenness in populations with moderate to high cardiovascular risk, such as persons with diabetes, is still unknown. Our aim was to evaluate the relationship between urban greenness and myocardial infarction incidence in persons with type 2 diabetes in Barcelona (Catalonia, Spain), and seek potential gender/sex differences in this association. This retrospective cohort study is based on data from the System for the Development of Research in Primary Care (SIDIAP database). We used Cox models to estimate if a 0.01 increase in Normalized Difference Vegetation Index (NDVI) at census tract level was associated to reduced risk of developing a myocardial infarction. Models were adjusted by demographic and clinical characteristics at individual level, and by environmental and socioeconomic variables at census tract level. Amongst 41,463 persons with diabetes and 154,803.85 person-years of follow-up, we observed 449 incident cases of acute myocardial infarction. For each 0.01 increment in NDVI the risk of developing a myocardial infarction decreased by 6% (Hazard Ratio, HR = 0.94; 95%CI, 0.89-0.99) in the population with diabetes. When stratifying by sex, we observed a significant association only in men (HR = 0.91; 95%CI, 0.86-0.97). People with diabetes living in urban greener areas might benefit from reduced cardiovascular risk, specially men. We observed sex/gender disparities, which could be related to different exposures and activities performed in green spaces between men and women. Further studies are needed to confirm sex/gender disparities between greenness exposure and cardiovascular outcomes. Our findings contribute to improve the health of people with diabetes who should be recommended to spent time and exercise in green areas.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1016/j.envres.2021.112449
- OA Status
- hybrid
- Cited By
- 18
- References
- 62
- Related Works
- 10
- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4200476395Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1016/j.envres.2021.112449Digital Object Identifier
- Title
-
Impact of residential greenness on myocardial infarction in the population with diabetes: A sex-dependent association?Work title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
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2021-12-06Full publication date if available
- Authors
-
Anna Ponjoan, Jordi Blanch, Lia Alves‐Cabratosa, Ruth Martí‐Lluch, Marc Comas‐Cufí, Marta Cirach, Mark Nieuwenhuijsen, Maria García-Gil, Rafel RamosList of authors in order
- Landing page
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https://doi.org/10.1016/j.envres.2021.112449Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1016/j.envres.2021.112449Direct OA link when available
- Concepts
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Medicine, Myocardial infarction, Hazard ratio, Diabetes mellitus, Population, Demography, Socioeconomic status, Type 2 diabetes, Environmental health, Cohort study, Incidence (geometry), Proportional hazards model, Gerontology, Internal medicine, Confidence interval, Endocrinology, Optics, Sociology, PhysicsTop concepts (fields/topics) attached by OpenAlex
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18Total citation count in OpenAlex
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2025: 8, 2024: 2, 2023: 2, 2022: 6Per-year citation counts (last 5 years)
- References (count)
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62Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| corresponding_author_ids | https://openalex.org/A5058855313 |
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| institutions_distinct_count | 9 |
| corresponding_institution_ids | https://openalex.org/I251424209, https://openalex.org/I4210129525 |
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| sustainable_development_goals[0].display_name | Sustainable cities and communities |
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