Association between community walkability and hypertension: Evidence from the Wuhan Chronic Disease Cohort Study

While community walkability is recognized as a key environmental factor for health status, evidence linking it specifically to hypertension is rather limited. To fill the knowledge gap, we concluded a cross-sectional study among 6421 eligible participants from the Wuhan Chronic Disease Cohort. A well-developed algorithm was performed to evaluate community walkability across Wuhan, quantified as Walk Score. We then calculated each participant residential Walk Score using the geographic information system. The logistic and linear regression models were conducted to determine the relationship between walkability, hypertension and blood pressure, respectively. We further performed the mediation analysis to explore potential mechanisms. After adjusting for extra confounders, we observed a higher community walk score was associated with a lower hypertension risk (OR = 0.73; 95% CI: 0.63, 0.84), a lower systolic blood pressure (β = -3.152 mmHg; 95% CI: -4.25, -2.05), a lower diastolic blood pressure (β = -2.237 mmHg; 95% CI: -2.95, -2.53) and a lower mean arterial pressure (β = -2.976 mmHg; 95% CI: -3.75, -2.20). The effect of community walkability on hypertension was partially mediated by body fat rate. Our study indicates a positive correlation between high walkability and a reduced odds of hypertension in China. This highlights the potential role of urban design in hypertension prevention, emphasizes the need for walkability-focused planning strategies to foster healthier communities, and guides future interventions and research to mitigate hypertension.