Residential environment, physical activity, and cardiovascular health in urban adults

Cardiovascular diseases remain the leading cause of global mortality. This study examined the joint and interactive effects of moderate-to-vigorous physical activity (MVPA) and residential environment infrastructure factor (REIF) on cardiovascular health indicators in an urban population. A cross-sectional study was conducted among 95 adults in Kaunas (Lithuania). Participants were categorized into MVPA tertiles. Cardiovascular outcomes included arterial pressure (aBP), including systolic (sBP) and diastolic blood pressure (dBP), pulse pressure (PP), daily heart rate (dHR), endurance coefficient (EC), adaptive potential (AP), and a composite health index (HI). Principal component analysis generated a composite behavioral–environmental–health index (AEH) explaining 71.3% of total variance. Structural equation modeling (SEM) assessed direct and interaction effects. Participants in the highest MVPA tertile exhibited significantly lower dHR, PP, and more favorable HI profiles compared with the lowest tertile. SEM demonstrated significant associations between MVPA and dHR and HI, as well as between REIF and dHR. A significant MVPA x REIF interaction was observed for dHR. The model explained up to 61% of variance in key cardiovascular outcomes. This study suggests that PA and REIF quality may be jointly associated with cardiovascular health.