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

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.