This study investigated the associations between greenness and blood pressure (BP) metrics (systolic BP [SBP], diastolic BP [DBP], hypertension) among urban adults in Bangladesh and the potential mediation effects of body mass index (BMI) using 2011 Bangladesh Demographic and Health Survey data for 2360 urban adults (aged ≥35 years). The Enhanced Vegetation Index was used as a measure of residential area greenness. Associations between greenness and BP metrics were estimated using linear and binary logistic regression models. We also conducted mediation analyses. Greater area-level greenness was inversely associated with SBP (β -1.33, 95%CI: -2.46, -.20), DBP (β -.83, 95%CI: -1.64, -.02), and hypertension (adjusted odds ratio .87, 95%CI: .77, .98). BMI substantially mediated associations between greenness and BP metrics. Adopting urban greening policies could reduce the risk of hypertension, thus can contribute to reduction of non-communicable disease burden in Bangladesh. Longitudinal studies are required to further investigate the causal pathways.
Keywords: Community greenness; adult health; blood pressure; hypertension; urbanisation.