New research from the European Society of Cardiology suggests that where you live—and how walkable your neighborhood is—can affect your risk of developing cardiovascular disease (CVD).
The study, led by Dr. Erik Timmermans from University Medical Center Utrecht, was presented at the ESC Preventive Cardiology 2025 congress and published in the journal Environmental Research.
The benefits of regular physical activity for heart health are well known. However, over a quarter of adults still do not meet the recommended 150 minutes of moderate physical activity per week.
One major factor that may influence daily activity levels is how easy it is to walk in a person’s neighborhood. Areas that are designed to encourage walking—those with sidewalks, green spaces, shops, and a mix of land use—may help residents stay more active by making walking a part of their daily routines.
To explore the long-term effects of neighborhood walkability on heart health, the researchers studied a large group of over 3 million Dutch adults aged 40 and older. None of the participants had a history of cardiovascular disease at the start of the study in 2009, and all of them lived at the same address throughout the 10-year follow-up period.
Using detailed geographic and population data, the research team measured how walkable each neighborhood was based on six factors: population density, how many shops and services were nearby, variety of land use (residential, commercial, etc.), number of street intersections, amount of green space, and availability of sidewalks.
They examined how these walkability features changed over time between 1996 and 2008 to see how long-term exposure to different environments influenced health.
From 2009 to 2019, about 21% of the participants developed cardiovascular disease. This included conditions like heart attacks and strokes, and over 81,000 people died from CVD during this period.
The study found that people living in areas with consistently low walkability had a 5.1% higher risk of developing any form of cardiovascular disease compared to those living in highly walkable neighborhoods.
Surprisingly, people who lived in areas where walkability improved over time still had a 4.9% higher risk of CVD compared to those in neighborhoods that were already walkable and remained that way.
These results suggest that just improving a neighborhood’s walkability later on might not be enough to quickly reverse the risks that come from long-term exposure to an inactive environment.
According to Dr. Timmermans, it’s possible that living in a less walkable area for years can lead to habits and health problems that aren’t easily changed, even if the environment later improves.
Interestingly, the study did not find significant links between walkability and heart failure or CVD-related deaths. The associations were stronger for general cardiovascular disease, including conditions like coronary heart disease and stroke.
Overall, the research highlights how important neighborhood design is for public health. Most people in the study lived in areas with low walkability, which means millions could be at higher risk simply because their neighborhoods don’t encourage physical activity.
Dr. Timmermans emphasized the importance of long-term urban planning, stating that thoughtful design of walkable communities could help reduce heart disease and improve population health.
This study adds to growing evidence that health is shaped not just by personal choices, but also by the environments people live in. Making cities and neighborhoods more walkable could be a powerful tool in preventing cardiovascular diseases and promoting healthier lifestyles.
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more health information, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
The research findings can be found in Environmental Research.
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