Moving to a Highly Walkable Neighborhood and Incidence of Hypertension: A Propensity-Score Matched Cohort Study.

BACKGROUND: The impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain. OBJECTIVE: Our study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. CITATION: 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.

Walk Score® and the prevalence of utilitarian walking and obesity among Ontario adults: A cross-sectional study.

BACKGROUND: Evidence from large, population-based studies about the association between neighbourhood walkability and the prevalence of obesity is limited. DATA AND METHODS: The study population consisted of 106,337 people aged 20 or older living in urban and suburban Ontario, who participated in the National Population Health Survey and the Canadian Community Health Survey from 1996/1997 to 2008. Based on their postal code, individuals were grouped into one of five walkability categories, ranging from very car-dependent to "Walker's Paradise," according to the Street Smart Walk Score®, a composite measure of neighbourhood walkability. Logistic regression models, adjusted for demographic, socioeconomic and lifestyle characteristics, were used to estimate odds ratios relating neighbourhood walkability to overweight/obesity and physical activity. RESULTS: Compared with residents of "Walker's Paradise" areas, those in very car-dependent areas had significantly higher odds of being overweight or obese. Despite similar levels of leisure physical activity among residents of all walkability areas, those in "Walker's Paradise" areas reported more utilitarian walking and weighed, on average, 3.0 kg less than did those in very car-dependent areas. INTERPRETATION: Living in a low-walkability area is associated with a higher prevalence of overweight/obesity. Neighbourhood walkability is related to the frequency of utilitarian walking.

Oxidative Aromatization, Cytotoxic Activity Evaluation and Conformational Study of Novel 7-aryl-10, 11-dihydro-7H-chromeno [4, 3-b]quinoline-6, 8(9H, 12H)-dione Derivatives.

In the present work, novel 7-aryl-10, 11-dihydro-7H-chromeno [4, 3-b]quinoline-6, 8(9H, 12H)-dione derivatives were synthesized by oxidation of 7-aryl-8, 9, 10, 12-tetrahydro-7H-chromeno[4, 3-b]quinoline-6, 8-diones in the presence of silica sulfuric acid/NaNO2 with yields of 64-74%. Cytotoxic activity of synthesized compounds was assessed on three different human cancer cell lines (K562, LS180, and MCF-7). Synthesized compounds showed moderate cytotoxic activities. The most active one apeared to be 2e, containing a methoxy group on the meta position of phenyl ring (IC50 range in different cell lines: 11.1-55.7 µM). Furthermore; comparison of the cytotoxic activity of these novel oxidized derivatives with non-oxidized counterparts revealed that oxidation of dihydropyridine ring to pyridine, improves the activity especially in LS180 cell line. Conformational analysis revealed that some conformational aspects of oxidized derivatives such as orientation of C7-aryl substitute were clearly different from non-oxidized ones.

A magnetic resonance perspective of the pulse wave transit time by the Arteriograph device and potential for improving aortic length estimation for central pulse wave velocity.

BACKGROUND: Simple reproducible methods of measuring arterial stiffness, a powerful index of prognosis, are becoming available. AIM: To compare the pulse wave transit time (TT) and pulse wave velocity (PWV) between MRI and an arm cuff-based oscillometric method, the Arteriograph. MATERIALS AND METHODS: MRI phase-contrast data were acquired at the aortic arch and just above the aortic bifurcation in 49 men (age 53±6 years). Supine left-arm Arteriograph measurements were made after MRI using the surface sternal notch to symphysis pubis pathway length. RESULTS: MRI TT and PWV covered 86% of aortic root-bifurcation length omitting a mean 4.7 cm of proximal ascending aorta. Arteriograph TT (71±9 ms) was 6.6 ms [95% confidence interval (CI) 3.9-9.4] or 10% higher than MRI (64±10 ms). Arteriograph PWV (7.9±1.3 m/s) was 1.33 m/s (95% CI 0.95-1.70) higher than MRI (6.6±1.2 m/s), primarily because the surface aortic length was 70 mm (95% CI 59-81) longer than MRI. Arteriograph-MRI PWV difference decreased to 0.31 m/s (95% CI 0.01-0.61) when Arteriograph PWV was calculated using the MRI aortic path length and to 0.25 m/s (95% CI -0.05 to 0.55) after correcting for the aortic segments omitted in the MRI method. After similar TT corrections for MRI, the Arteriograph-MRI difference in TT reduced to 3.2 ms (95% CI 0.2-6). CONCLUSION: TT estimations by Arteriograph and MRI are close. More accurate length estimation from MRI-derived models improves Arteriograph PWV measurement.

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000.

The objective of this study was to compare central systolic blood pressure (cSBP) and augmentation index (AIx) from two recently introduced devices, Omron HEM-9000 (OM) and Arteriograph (AG), not using a transfer function with those of the widely used SphygmoCor (SC) calibrated on brachial blood pressure like OM. Random-order manufacturer-recommended measurements using SC and OM by radial tonometry and AG were taken on the left arm in 35 men (54±10 years) after 5 min supine rest. Results are means (95% confidence interval) of differences using paired t-tests. cSBP by OM was 4.1 (1.0-7.1) mm Hg higher than by AG. Both OM and AG estimated the mean cSBP to be significantly higher than did SC (114.8 mm Hg) by 12.5 (10.3-14.7) and 8.6 (4.9-12.3) mm Hg, respectively, although closely correlating with SC (r=0.9). Calibrating SC with diastolic blood pressure (DBP) and more accurate mean arterial pressure (as DBP+0.4 × PP) resulted in significantly higher cSBP statistically not different from AG's cSBP: 0.9 (-1.1 to +2.9) mm Hg, and closer to OM's: 5.1 (3.4-6.8) mm Hg. Radial AIx from SC and OM disagreed by 3 (0.7-5.4)%, and correlated (r=0.8) with AG's brachial AIx. AG's aortic AIx was 7.9 (5.7-10.2)% higher than SC's, but closely correlated (r=0.9). Clinically significant, higher cSBP measured by AG, OM and more accurately calibrated SC adds to previous data suggesting that SC measurements by classic calibration underestimate cSBP. Invasive studies involving all three devices would be more illuminating.

Ethnic differences in aortic pulse wave velocity occur in the descending aorta and may be related to vitamin D.

We studied aortic pulse wave velocity (aPWV), a predictor of cardiovascular events independent of blood pressure, in a multiethnic sample of British men, to investigate the roles for blood levels of vitamin D and aldosterone in total and regional aortic stiffness. Total aPWV was estimated noninvasively by the Arteriograph device (aPWV(AG)) in 198 men, with its length measure calibrated by magnetic resonance. PWVs over the aortic arch and descending aorta were measured by magnetic resonance in a subsample (n=47). Mean (SE) aPWV(AG) in South Asians (n=68; age 55±10 years), at known higher coronary disease risk than other groups, was 0.5 m/s (0.2 m/s) higher than in African Caribbeans (n=67; 55±10 years), at lowest coronary disease risk here, and Europeans (n=63; 57±8 years), adjusted for age, systolic blood pressure, and diabetes mellitus (P=0.01). By magnetic resonance, PWV over the descending aorta in South Asians was 0.7 m/s (0.3 m/s) and 0.8 m/s (0.3 m/s) higher than in African Caribbeans and Europeans, respectively; PWV over the aortic arch was not different. South Asians and African Caribbeans had 21 nmol/L (3 nmol/L) and 14 nmol/L (3 nmol/L) lower mean (SE) 25(OH)D than Europeans (P<0.001). Unlike aldosterone, 25(OH)D was negatively correlated with aPWV(AG) adjusted for age and systolic blood pressure, as well as weakened or removed ethnic differences in aPWV(AG) in regression models. These data suggest that aortic stiffness as aPWV parallels coronary disease risk in ethnic groups, descending aortic but not arch PWV has this feature, and serum 25(OH)D is an independent negative correlate of aPWV and may partly account for ethnicity-related differences in aPWV and coronary disease risk.