The Role of Urban Built Environment in Enhancing Cardiovascular Health in Chinese Cities: A Systematic Review

Urban built environments in Chinese cities have increasingly been shown to not only influence human health outcomes but also promote sustainable urban development pathways. These health and sustainability advantages have had significant implications for cardiovascular disease (CVD) prevention and management. CVD represents a growing public health challenge in China’s rapidly urbanizing contexts. However, people living in poorly designed built environments receive less attention and tend to experience disproportionate cardiovascular health risks due to limited access to health-promoting environmental features. Therefore, this systematic review emphasizes the role of urban built environments in shaping cardiovascular health outcomes. Previous studies have highlighted the importance of spatial indicators, such as the Normalized Difference Vegetation Index (NDVI), green space ratio, walkability, and public open space, in influencing cardiovascular health. Using various common cardiovascular diseases and their risk factors as outcome measures, this review conducted a comprehensive literature search across CNKI, Web of Science, Scopus, and PubMed. The search aimed to identify studies examining the associations between urban built environments and cardiovascular health outcomes, in order to synthesize and present the research progress in this field. Through this review, we find that physical activity serves as the key mediating mechanism linking built environment characteristics to cardiovascular outcomes. Based on this finding, this review argues that urban built environment design and sustainable urbanism should prioritize cardiovascular health considerations in the planning process, as this health-oriented approach has the greatest potential for advancing public health resources and moving cities closer to being truly sustainable and health-promoting environments.