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A typology of neighborhoods and blood pressure in the RECORD Cohort Study

Van Hulst, Andraeaa,b; Thomas, Frédériquec; Barnett, Tracie A.a,b; Kestens, Yana,d; Gauvin, Lisea,d,e; Pannier, Brunoc; Chaix, Basilef,g

doi: 10.1097/HJH.0b013e3283544863
ORIGINAL PAPERS: Epidemiology
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Background: Studies of associations between neighborhood environments and blood pressure (BP) have relied on imprecise characterizations of neighborhoods. This study examines associations between SBP and DBP and a neighborhood typology based on numerous residential environment characteristics.

Methods: Data from the Residential Environment and Coronary Heart Disease Study involving 7290 participants recruited in 2007–2008, aged 30–79 years, and residing in the Paris metropolitan area were analyzed. Cluster analysis was applied to measures of the physical, services and social interactions aspects of neighborhoods. Six contrasting neighborhood types were identified and examined in relation to SBP and DBP using multivariable linear regression, adjusting for individual/neighborhood socioeconomic status and individual risk factors for hypertension.

Results: The neighborhood typology included suburban to central urban neighborhood types with varying levels of adverse social conditions. SBP was 2–3 mmHg higher among participants residing in suburban neighborhood types and in the urban with low social standing neighborhood type, compared to residents of central urban with intermediate social standing neighborhoods (reference). The association between residing in urban low social standing neighborhoods and SBP remained after adjusting for individual/neighborhood socioeconomic status and individual risk factors for hypertension. Overall, an inverse association between DBP and level of urbanicity of the neighborhood was observed, even after adjustment for individual risk factors for hypertension.

Conclusions: Variations in BP were observed by levels of urbanicity and social conditions of residential neighborhoods, with different patterns for SBP and DBP. Population interventions to reduce hypertension targeted towards specific neighborhood types hold promise.

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aDepartment of Social and Preventive Medicine, Faculty of Medicine, Université de Montréal

bCentre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada

cCentre d’Investigations Préventives et Cliniques, Paris, France

dCentre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM)

eCentre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal, Université de Montréal, Montreal, Quebec, Canada

fInserm

gUniversité Pierre et Marie Curie-Paris6, UMR-S 707, Paris, France

Correspondence to Andraea van Hulst, Centre de recherche du CHU Sainte-Justine, 5757 Avenue Decelles, suite 106, Montréal, Québec H3S 2C3, Canada. Tel: +1 514 345 4931; fax: +1 514 345 4801; e-mail: a.van.hulst@umontreal.ca

Abbreviations: BP, blood pressure; b.p.m., beats per minute; RECORD Study, Residential Environment and Coronary Heart Disease Study

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com).

Received 9 September, 2011

Revised 12 January, 2012

Accepted 30 March, 2012

© 2012 Lippincott Williams & Wilkins, Inc.