A typology of neighborhoods and blood pressure in the RECORD Cohort Study.

BACKGROUND Studies of associations between neighborhood environments and blood pressure (BP) have relied on imprecise characterizations of neighborhoods. This study examines associations between SBP and DBP and a neighborhood typology based on numerous residential environment characteristics. METHODS Data from the Residential Environment and Coronary Heart Disease Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Cluster analysis was applied to measures of the physical, services and social interactions aspects of neighborhoods. Six contrasting neighborhood types were identified and examined in relation to SBP and DBP using multivariable linear regression, adjusting for individual/neighborhood socioeconomic status and individual risk factors for hypertension. RESULTS The neighborhood typology included suburban to central urban neighborhood types with varying levels of adverse social conditions. SBP was 2-3 mmHg higher among participants residing in suburban neighborhood types and in the urban with low social standing neighborhood type, compared to residents of central urban with intermediate social standing neighborhoods (reference). The association between residing in urban low social standing neighborhoods and SBP remained after adjusting for individual/neighborhood socioeconomic status and individual risk factors for hypertension. Overall, an inverse association between DBP and level of urbanicity of the neighborhood was observed, even after adjustment for individual risk factors for hypertension. CONCLUSIONS Variations in BP were observed by levels of urbanicity and social conditions of residential neighborhoods, with different patterns for SBP and DBP. Population interventions to reduce hypertension targeted towards specific neighborhood types hold promise.