Public policies that make it easier to incorporate physical activity into daily life have the potential to increase participation in physical activity on a broad scale. 9, 10, 11, 12, 13 While national guidelines recommend that all adults accumulate a minimum of 150 minutes of moderate to high intensity physical activity each week, 14, 15 nearly 1 in 4 American adults do not engage in any form of leisure‐time physical activity.

2, 3, 4, 5, 6, 7, 8 The protective relationship between physical activity and cardiovascular risk is likely mediated in large part through effects on body weight and visceral adiposity, leading to improvements in insulin sensitivity and downstream metabolic processes. 1 Regular physical activity is associated with a better cardiometabolic risk profile, including a lower risk of diabetes mellitus, hypertension, and major cardiovascular events. Dose–response associations were observed for systolic blood pressure, high‐density lipoprotein cholesterol, and diabetes mellitus risk, while an inverse association was observed with smoking status.Ĭardiovascular disease remains one of the most common causes of morbidity and mortality globally. Fully adjusted analyses found a nonlinear relationship between walkability and predicted 10‐year cardiovascular disease risk (least versus most walkable neighborhood: odds ratio =1.09, 95% CI: 0.98, 1.22), with the greatest difference between Q3 and Q5 (odds ratio=1.33, 95% CI: 1.23, 1.45). In total, 44 448 individuals were included in our analyses. Secondary outcomes included measured systolic blood pressure, total and high‐density lipoprotein cholesterol levels, prior diabetes mellitus diagnosis, and current smoking status. Adjusted associations were estimated using logistic regression models. The primary outcome was a predicted 10‐year cardiovascular disease risk of ≥7.5% (recommended threshold for statin use) assessed by the American College of Cardiology/American Heart Association Pooled Cohort Equation.

Walkability was assessed using a validated index based on population and residential density, street connectivity, and the number of walkable destinations in each neighborhood, divided into quintiles (Q). We studied residents living in major urban centers in Ontario, Canada on January 1, 2008, using linked electronic medical record and administrative health data from the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) cohort. Conclusions In our setting, adults living in less walkable neighborhoods had a higher predicted 10-year cardiovascular disease risk than those living in highly walkable areas.

Dose-response associations were observed for systolic blood pressure, high-density lipoprotein cholesterol, and diabetes mellitus risk, while an inverse association was observed with smoking status. Fully adjusted analyses found a nonlinear relationship between walkability and predicted 10-year cardiovascular disease risk (least versus most walkable neighborhood: odds ratio =1.09, 95% CI: 0.98, 1.22), with the greatest difference between Q3 and Q5 (odds ratio=1.33, 95% CI: 1.23, 1.45). Secondary outcomes included measured systolic blood pressure, total and high-density lipoprotein cholesterol levels, prior diabetes mellitus diagnosis, and current smoking status. The primary outcome was a predicted 10-year cardiovascular disease risk of ≥7.5% (recommended threshold for statin use) assessed by the American College of Cardiology/American Heart Association Pooled Cohort Equation.

Methods and Results We studied residents living in major urban centers in Ontario, Canada on January 1, 2008, using linked electronic medical record and administrative health data from the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) cohort. It is unclear whether neighborhood walkability is a risk factor for future cardiovascular disease. Background Individuals living in unwalkable neighborhoods appear to be less physically active and more likely to develop obesity, diabetes mellitus, and hypertension.

Unwalkable suburbs