The built environment and cardiovascular disease: an umbrella review and meta-meta-analysis

27 July 2023

PhD student and researcher Mingwei Liu (UMC Utrecht) and colleagues searched seven databases for systematic reviews on associations between objectively measured long-term built environmental exposures, covering at least one domain (i.e., outdoor air pollution, food environment, physical activity environment like greenspace and walkability, urbanisation, light pollution, residential noise, and ambient temperature), and CVD events in adults. Two authors extracted summary data and assessed the risk of bias independently. Robustness of evidence was rated based on statistical heterogeneity, small-study effect and excess significance bias. Meta-meta analyses were conducted to combine the meta-analysis results from reviews with comparable exposure and outcome within each domain.

From the 3,304 initial hits, 51 systematic reviews were included, covering five domains and including 179 pooled estimates. There was strong evidence of the associations between increased air pollutants (especially PM2.5 exposure) and increased residential noise with greater risk of CVD. Highly suggestive evidence was found for an association between increased ambient temperature and greater risk of CVD. Systematic reviews on physical activity environment, food environment, light pollution and urbanisation in relation to CVD were scarce or lacking.


Decoding the exposome

Decoding the exposome

The environment we live in has a dominant impact on our health. It explains an estimated seventy percent of the chronic disease burden. Where we live, what we eat, how much we exercise, the air we breathe and whom we associate with; all of these environmental factors play a role. The combination of these factors over the life course is called the exposome. There is general (scientific) consensus that understanding more about the exposome will help explain the current burden of disease and that it provides entry points for prevention and ...

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