AIMS To provide a comprehensive overview of the current evidence on objectively measured neighbourhood built environment exposures in relation to cardiovascular disease (CVD) events in adults. METHODS AND RESULTS We searched seven databases for systematic reviews on associations between objectively measured long-term built environmental exposures, covering at least one domain (i.e. outdoor air pollution, food environment, physical activity environment like greenspace and walkability, urbanization, light pollution, residential noise, and ambient temperature), and CVD events in adults. Two authors extracted summary data and assessed the risk of bias independently. Robustness of evidence was rated based on statistical heterogeneity, small-study effect, and excess significance bias. Meta-meta-analyses were conducted to combine the meta-analysis results from reviews with comparable exposure and outcome within each domain. From the 3304 initial hits, 51 systematic reviews were included, covering 5 domains and including 179 pooled estimates. There was strong evidence of the associations between increased air pollutants (especially PM2.5 exposure) and increased residential noise with greater risk of CVD. Highly suggestive evidence was found for an association between increased ambient temperature and greater risk of CVD. Systematic reviews on physical activity environment, food environment, light pollution, and urbanization in relation to CVD were scarce or lacking. CONCLUSION Air pollutants, increased noise levels, temperature, and greenspace were associated with CVD outcomes. Standardizing design and exposure assessments may foster the synthesis of evidence. Other crucial research gaps concern the lack of prospective study designs and lack of evidence from low-to-middle-income countries (LMICs). REGISTRATION PROSPERO: CRD42021246580.

中文翻译：

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建筑环境和心血管疾病：总体回顾和荟萃分析。

目的 全面概述客观测量的邻里建筑环境暴露与成人心血管疾病 (CVD) 事件相关的当前证据。方法和结果 我们检索了七个数据库，对客观测量的长期建筑环境暴露之间的关联进行系统评价，涵盖至少一个领域（即室外空气污染、食品环境、体育活动环境（如绿地和步行性）、城市化、光污染、住宅噪音和环境温度）以及成人的 CVD 事件。两位作者提取汇总数据并独立评估偏倚风险。证据的稳健性是根据统计异质性、小规模研究效应和过度显着性偏倚来评估的。进行荟萃分析，将评论的荟萃分析结果与每个领域内可比较的暴露和结果结合起来。从 3304 条初步点击中，纳入了 51 条系统评价，涵盖 5 个领域，包括 179 项汇总估计。有强有力的证据表明，空气污染物增加（尤其是 PM2.5 暴露）和住宅噪音增加与 CVD 风险增加之间存在关联。高度提示性的证据表明环境温度升高与心血管疾病风险增加之间存在关联。与CVD相关的体力活动环境、食品环境、光污染和城市化的系统评价很少或缺乏。结论 空气污染物、噪音水平增加、温度和绿地与 CVD 结局相关。标准化设计和暴露评估可能会促进证据的综合。其他重要的研究差距涉及缺乏前瞻性研究设计和缺乏来自中低收入国家（LMIC）的证据。注册普洛斯彼罗：CRD42021246580。