The results of a cross-sectional study reported in JACC: CardioOncology by Nwana et al revealed a significant association between the extent to which a neighborhood facilitates walking and the burden of modifiable cardiovascular risk factors among patients with a history of cancer.
“[The findings from our study] urge [policymakers] to change the narrative and prioritize the implementation of policies aimed at improving the built environment, particularly the walkability, of low-income neighborhoods,” the investigators remarked. “Such initiatives have the potential to improve the cardiovascular health of residents in these neighborhoods, including those living with cancer.”
Study Details
Using data from the Houston Methodist Learning Health System Outpatient Registry from 2016 to 2022, the investigators identified 121,109 patients (mean age = 67.3 years) with a history of cancer and an available 2019 Walk Score who were distributed across 704 neighborhoods. Of this cohort, 22,750 individuals had atherosclerotic cardiovascular disease.
Neighborhood Walk Scores were categorized into four walkability groups: 0 to 24 (car-dependent for all errands); 25 to 49 (car-dependent for most errands); 50 to 69 (somewhat walkable); and 70 to 100 (very walkable/walker’s paradise). The investigators examined the prevalence of modifiable cardiovascular risk factors (ie, hypertension, diabetes, smoking, dyslipidemia, and obesity) and their associations with the neighborhood walkability categories in the study population.
Neighborhood Walkability and Cardiovascular Risk Factors
A total of 76.7% and 86.0% of the patients residing in the most vs least walkable neighborhoods, respectively, exhibited at least one modifiable cardiovascular risk factor. According to the investigators, the former population showed a decreased likelihood of having hypertension, diabetes, obesity, a history of smoking, or any cardiovascular risk factor. Patients living in very walkable/walker’s paradise neighborhoods were found to be 16% less likely to have any risk factor than those who were car-dependent for all errands (adjusted odds ratio = 0.84). The sensitivity analyses, which considered the timing of events, seemed to yield comparable findings.
“Investments in walkable neighborhoods may present a viable opportunity for mitigating the growing burden of modifiable cardiovascular risk factors among patients with a history of cancer,” the investigators concluded. “By integrating interventions at the neighborhood level, health-care providers can contribute to more holistic patient care approaches, potentially leading to improved outcomes in this population.”
They noted that further research should focus on assessing how neighborhood walkability may impact the incidence of cardiovascular disease risk factors during and after the treatment of those with active cancer.
Khurram Nasir, MD, MPH, MSc, of DeBakey Heart & Vascular Center, Houston Methodist Hospital, is the corresponding author of the JACC: CardioOncology article.
Disclosure: For full disclosures of the study authors, visit jacc.org.
