Neighborhood Environments and Incident Hypertension in the Multi-Ethnic Study of Atherosclerosis

Am J Epidemiol. 2016 Jun 1;183(11):988-97. doi: 10.1093/aje/kwv296. Epub 2016 May 8.


We examined relationships between neighborhood physical and social environments and incidence of hypertension in a cohort of 3,382 adults at 6 sites in the United States over 10 years of follow-up (2000-2011), using data from the Multi-Ethnic Study of Atherosclerosis. The sample was aged 45-84 years (mean = 59 years) and free of clinical cardiovascular disease and hypertension at baseline. Of the participants, 51% were female, 44% white, 23% Hispanic, 21% black, and 13% Chinese-American; 39% of participants developed hypertension during an average of 7.2 years of follow-up. Cox models were used to estimate associations of time-varying cumulative average neighborhood features (survey-based healthy food availability, walking environment, social cohesion, safety, and geographic information system-based density of favorable food stores and recreational resources) with incident hypertension. After adjustment for individual and neighborhood-level covariates, a 1-standard-deviation increase in healthy food availability was associated with a 12% lower rate of hypertension (hazard ratio = 0.88, 95% confidence interval: 0.82, 0.95). Other neighborhood features were not related to incidence of hypertension. The neighborhood food environment is related to the risk of hypertension.

Keywords: hypertension; longitudinal studies; neighborhoods.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cross-Sectional Studies
  • Environment*
  • Female
  • Food Supply / statistics & numerical data*
  • Health Behavior
  • Humans
  • Hypertension / ethnology*
  • Incidence
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Racial Groups / statistics & numerical data*
  • Residence Characteristics / statistics & numerical data*
  • Risk Factors
  • Safety / statistics & numerical data
  • Social Environment
  • Socioeconomic Factors
  • Sports and Recreational Facilities / statistics & numerical data
  • Time Factors
  • United States / epidemiology
  • Walking