Urbanization and systolic/diastolic blood pressure from a gender perspective: Separating longitudinal from cross-sectional association

• Published in: Health & place Vol. 75; p. 102778
• Main Authors: Wu, Jinjing, Jiao, Boshen, Fan, Yanchen
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2022; Elsevier Science Ltd
• Subjects: Averages; Blood pressure; Cardiovascular diseases; Cardiovascular health; China; Gender; Gender disparity; Heterogeneity; Infectious diseases; Men; Nutrition; Nutrition surveys; Statistical significance; Urbanization; Women; Urbanization; Cardiovascular health; China; Gender disparity
• ISSN: 1353-8292; 1873-2054
• DOI: 10.1016/j.healthplace.2022.102778

There has been a generally negative view of the impact of urbanization on a rising burden of non-communicable diseases including cardiovascular disease. However, the evidence on the relationship between urbanization and cardiovascular health has remained inconclusive. A comprehensive picture of the relationship is lacking, given an implicit assumption that the longitudinal association between changes in cardiovascular health and an increasingly urbanized environment is similar between less and more urbanized communities, men and women. We used the longitudinal data on adults (18–64 years) from the China Health and Nutrition Survey (1991–2015) and employed within-between random-effects models to disaggregates the longitudinal and cross-sectional associations between urbanization and systolic/diastolic blood pressure (SBP/DBP) and examined heterogeneities in the longitudinal association by average urbanization level and gender. We found that the positive longitudinal association of urbanization with SBP/DBP was stronger in less urbanized than more urbanized communities. The cross-sectional association between urbanization and SBP was negative and significant, although the cross-sectional association between urbanization and DBP was of no statistical significance. Moreover, the positive longitudinal association between urbanization and DBP was stronger among men than women, although the gender heterogeneity in the longitudinal association of urbanization with SBP was not significant. •People had an increase in systolic/diastolic blood pressure as their communities became more urbanized.•The increase in systolic/diastolic blood pressure associated with an increasingly urbanized environment was larger in less urbanzied than more urbanized communities.•People living in a community with a higher average urbanization level had a lower level of systolic blood pressure.•The positive longitudinal association between urbanization and diastolic blood pressure was more pronounced in men than women.