# The Association Between Urbanization and Electrocardiogram Abnormalities in China: a Nationwide Longitudinal Study

## TL;DR

This study finds that urbanization in China is linked to lower risks of ECG abnormalities, suggesting potential cardiovascular benefits.

## Contribution

The study introduces a novel nationwide longitudinal analysis linking urbanization metrics to subclinical cardiovascular risks.

## Key findings

- Higher urbanization levels correlate with reduced odds of ECG abnormalities.
- A U-shaped relationship exists between urbanization and ECG abnormalities.
- Urbanization currently benefits cardiovascular health in Chinese adults.

## Abstract

The health effects of urbanization are controversial. The association between urbanization and reversible subclinical risks of cardiovascular diseases (e.g., electrocardiogram (ECG) abnormalities) has rarely been studied. This study aimed to assess the association between urbanization and ECG abnormalities in China based on the China National Stroke Screening Survey (CNSSS). We used changes in the satellite-measured impervious surfaces rate and nighttime light data to assess the level of urbanization. Every interquartile increment in the impervious surfaces rate or nighttime light was related to a decreased risk of ECG abnormalities, with odds ratios of 0.894 (95% CI, 0.869–0.920) or 0.809 (95% CI, 0.772–0.847), respectively. And we observed a U-shaped nonlinear exposure–response relationship curve between the impervious surfaces rate and ECG abnormalities. In conclusion, the current average level of urbanization among the studied Chinese adults remains a beneficial factor for reducing cardiovascular risks.

The online version contains supplementary material available at 10.1007/s11524-023-00816-w.