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

Paulina Kaiser*, Ana V. Diez Roux, Mahasin Mujahid, Mercedes Carnethon, Alain Bertoni, Sara D. Adar, Steven Shea, Robyn McClelland, Lynda Lisabeth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)988-997
Number of pages10
JournalAmerican journal of epidemiology
Issue number11
StatePublished - Jun 1 2016


  • hypertension
  • longitudinal studies
  • neighborhoods

ASJC Scopus subject areas

  • Epidemiology

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