Residential greenspace and blood lipids in an essential hypertension population: Mediation through PM <subscript>2.5</subscript> and chemical constituents.

Fine particulate matter (PM 2.5 ) adversely affects blood lipids, while residential greenspace exposure may improve blood lipids levels. However, the association between exposure to residential greenspace and blood lipids has not been adequately studied, especially in vulnerable populations (e.g. people with essential hypertension). This study aimed to assess the association between residential greenspace exposure and blood lipids, and to clarify whether PM 2.5 and chemical constituents was mediator of it. We used a period (May 2010 to December 2011) from the Chinese national hypertension project. The residential greenspace was estimated using satellite-derived normalized difference vegetation index (NDVI). The generalized additive mixed model (GAMM) was used to assess the association between exposure to residential greenspace and blood lipids, and the mediation model was used to examine whether there was a mediating effect of PM 2.5 and chemical constituents on that association. The exposure to residential greenspace was negatively associated with the decreased risk of dyslipidemia, especially short-term exposure. For example, the odd ratio short-term for dyslipidemia was 0.915 (95% CI：0.880 to 0.950). This association was strengthened by physical activity and participants living in the North. PM 2.5 and chemical constituents were important mediators in this association, with the proportion of mediators ranging from -5.02% to 26.33%. The association between exposure to residential greenspace and dyslipidemia in this essential hypertensive population, especially participants living in the North and doing daily physical activity, was mediated by PM 2.5 and chemical constituents.

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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