The effect of urban green space on the risk of coronary events within one year in patients with acute coronary syndromes

Abstract

Background and Aims: There is evidence that exposure to green environments is associated with health benefits. The aim of this study was to investigate relationship between urban green space (UGS) and coronary events (CE) in one year period after hospital admission in patients with acute coronary syndromes (ACS). Methods: We used data of 1,022 patient’s who lived in Kaunas and were treated for ACS in Hospital of Lithuanian University of Health Sciences during 2004-2005 and survived more than 14 days.Patient’s home locations were mapped using the ArcGIS 9.2 Geographical Information System (GIS) and combined with a comprehensive GIS database of urban green space and main street characteristics. We estimated patients residence distance from UGS classified as a Formal park and main street.According to the distance from the residents’ homes to the main street and green space we determined three patient’s groups by tertiles. The associations between distance from UGSand the risk of CE were analyzed by multivariate logistic regression, adjusting for patient’s age, prior peripheral artery disease and stroke,pulmonary hypertension, low high density lipoprotein cholesterol, coronary artery stenosis, heart rate, ejection fraction, myocardial revascularization), and patients residence distance from main street. Results:The adjusted odds ratios (95% CI) for CE in patients, survived > 60 days after hospitalization, residing close to 350 m, within 350-700 m, and further 700 mfrom park were, respectively, 1, 1.23 (0.56-2.72), 2.33 (1.11-4.92). An UGS distance rise of 100 m was associated with an increase of CE risk by 1.06 (1.01-1.12). We found stronger associations between home distance to thepark and CE for men: the adjusted odds ratios were 1, 2.02 (0.67-6.10), 4.19 (1.46-12.0). Conclusion: Living close to urban green space was associated with lower risk of coronary events in one year period in patients with ACS [...].