Influence of urban and transport planning and the city environment on cardiovascular disease

This Review describes the relationship between urban and transport planning and the city environment, the main cardiovascular risk factors (including physical activity, hypertension, and obesity), and cardiovascular disease and mortality. Good evidence exists for a relationship between built environment measures (such as mixed land use, connectivity and walkability, and physical activity), environmental exposures (such as green space, air pollution, and noise), and cardiovascular disease and mortality. Some good evidence exists for a link between transport mode and cardiovascular disease, but evidence is inconsistent for an association between built environment measures and weight status, and between green space and either weight status or physical activity. Further research is needed into the influence of built environment measures on cardiovascular disease and mortality. Urban and transport planning has an important effect on cardiovascular health and its risk factors. Cardiovascular disease and mortality could be reduced by better urban and transport planning that promotes physical activity; reduces levels of air pollution, noise, and heat island effects; and increases green space. Key points Urban and transport planning affects cardiovascular health and its risk factors, including hypertension, physical activity, and obesity. Good evidence exists for a relationship between built environment measures (mixed land use, connectivity and walkability, and physical activity), environmental exposures (green space, air pollution, and noise), and cardiovascular disease and mortality. Cardiovascular disease and mortality could be reduced by improved urban and transport planning that promotes physical activity; reduces levels of air pollution, noise, and heat island effects; and increases green space. A move away from car-centric sprawling cities towards more compact, less car-dependent cities, and greener cities with mixed land use, more public and active transport, and greener infrastructure is needed. Health impact assessment tools have become available to estimate the health effects of healthy urban and transport planning and should be used to promote further healthy development. This Review describes the relationship between urban and transport planning and the city environment, the main cardiovascular risk factors (including physical activity, hypertension, and obesity), and cardiovascular disease and mortality. Improved city planning that promotes physical