Heart failure & cardiomyopathiesCohort study
Association of residential green space, blue space, and natural environment with the incident heart failure and cardiac morpho-functional phenotypes: a UK biobank-based prospective cohort and imaging study
- Prospective cohort study
- UK Biobank
- Cardiac magnetic resonance (CMR) imaging substudy
Authors' conclusion
Residential exposure to green space, blue space, and natural environments is associated with lower HF incidence and healthier cardiac phenotypes, independent of genetic predisposition and air pollution. Green space demonstrates the most robust cardioprotective effects.
Study context
- Population
- UK Biobank participants free of baseline heart failure (HF), enrolled 2006–201016,564 incident HF cases
- Participants
- 437,429 participants
- Exposure
- Higher vs lower residential green space, blue space and natural environment exposure (3rd vs 1st tertile)
- Outcome
- Incident HF
- Follow-up
- Median 13.9 (IQR: 13.1, 14.5) years
Main finding
As reported in the abstract
Incident HF, 1000-m buffer
3rd tertile vs 1st tertileHazard ratio (95% CI)
green space
0.87(0.82–0.92)
blue space
0.77(0.75–0.80)
natural environment
0.85(0.80–0.90)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| CMR remodelling, green space, 1000-m buffer — Higher green space vs 1st tertile · concentric remodelling | 0.72 (0.54–0.96) | |
| CMR remodelling, green space, 1000-m buffer — Higher green space vs 1st tertile · eccentric hypertrophy | 0.66 (0.55–0.79) | |
| CMR remodelling, green space, 1000-m buffer — Higher green space vs 1st tertile · concentric hypertrophy | 0.29 (0.13–0.63) | |
| CMR remodelling, blue space, 1000-m buffer — Higher blue space vs 1st tertile · outcome not named in the abstract | 0.73 (0.59–0.90) | |
| CMR remodelling, blue space, 1000-m buffer — Higher blue space vs 1st tertile · concentric hypertrophy | 0.43 (0.25–0.76) | |
| 0.10.31310Odds ratio (log scale) |
Incident HF, 300-m buffer
- Similar trends, with comparable protective associations for green space, blue space and natural environment
CMR remodelling, natural environment, 1000-m buffer
- Attenuation of adverse remodelling comparable to green space effects
Original publication
Association of residential green space, blue space, and natural environment with the incident heart failure and cardiac morpho-functional phenotypes: a UK biobank-based prospective cohort and imaging study. Eur J Prev Cardiol. Published 24 February 2026. doi:10.1093/eurjpc/zwag084
Summarised from the published abstract; every number is checked against it