Figure of Kaunas city, indicating the areas of noise and hypertension.

Only few studies have previously examined the relation between urban built environment and the prevalence of hypertension. A cross-sectional study, led by the researcher Regina Grazuleviciene, from the Department of Environmental Science at the Vytautas Magnus University (Lithuania), aimed at assessing the relationship between the environmental quality, physical activity, and stress on hypertension among citizens of Kaunas city, Lithuania. This study, developed in the framework of the H2020 CitieS-Health project, provides evidence that improvement of the district-level built environment supporting citizens’ physical activity might reduce the risk of hypertension.


“We developed a survey of 1086 citizens residing in 11 districts in Kaunas to determine their perceptions of environmental quality, health behavior, and health indices”, explains Grazuleviciene about this paper published in the International Journal of Environmental Research in Public Health. The independent variables included residential traffic flows, access to public transportation and green spaces. Dependent variables included physician-diagnosed hypertension, systolic and diastolic blood pressure, and stress level.


The researchers used multivariable logistic regression to assess the associations as odds ratios (OR), a measure of association between exposure and an outcome. The environmental factors beneficially associated with meeting the physical activity recommendations were opportunities for walking to reach the city’s green spaces and available relaxation areas. “Residents of high noise level districts aged 45–64 years had a significantly higher OR of stress and a higher prevalence of hypertension when age, sex, education status, family status, and smoking were accounted for. However, meeting the physical activity recommendations had a beneficial effect on the risk of hypertension”, concludes the researcher.



Urban Environment and Health: A Cross-Sectional Study of the Influence of Environmental Quality and Physical Activity on Blood Pressure.  Grazuleviciene, R. et al. Int. J. Environ. Res. Public Health 2021, 18(11), 6126; Published: 6 June 2021 (This article belongs to the Special Issue Evidence for Healthy Urban Design)