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Applying g-computation, we estimated the effects of hypothetical reductions of PM2.5, BC, NO2, and increases of NDVI on the incidence of pre-\/hypertension over a 6-year period compared with no intervention. The observed risk of developing pre-\/hypertension was 14.4%. We found a dose-dependent relationship showing higher risk reductions when imposing lower hypothetical levels or larger percental reductions for the air pollutants. The largest effects were observed for PM2.5, e.g. reducing PM2.5 to \u226410\u2005\u03bcg\/m3 lowered the risk of developing pre-\/hypertension by \u221210.7 [\u221214.1, \u22125.7; 95% bootstrap CI] percentage points compared with no intervention. Effects of BC reductions were less strong, e.g. \u22125.3 [\u221210.2, 1.7] when reducing BC to \u22640.8 \u00d7 10\u22125\/m and small (non-significant) effects were found for NO2. Hypothetically increasing NDVI to \u22650.6 lowered the pre-\/hypertension risk by \u22121.5 [\u22122.9, \u22120.4]. Sensitivity analyses suggested effects of air pollution mainly on systolic (SBP) but not diastolic blood pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adherence to recommended levels of air pollutants and increased greenness can help to prevent hypertension among children and adolescents. Efforts to reduce air pollution could thus reduce the cardiovascular disease burden in later life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf600","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T10:12:40Z","timestamp":1758622360000},"page":"1601-1611","source":"Crossref","is-referenced-by-count":2,"title":["Effects of ambient air pollutants and environmental greenness on the incidence of pre-\/hypertension in children and adolescents"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4943-2141","authenticated-orcid":false,"given":"Maike","family":"Wolters","sequence":"first","affiliation":[{"name":"Leibniz Institute for Prevention Research and Epidemiology\u2014BIPS , Achterstrasse 30, Bremen D-28359 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajini","family":"Nagrani","sequence":"additional","affiliation":[{"name":"Leibniz Institute for 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A","family":"Moreno","sequence":"additional","affiliation":[{"name":"GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Arag\u00f3n (IA2), Instituto de Investigaci\u00f3n Sanitaria de Arag\u00f3n (IIS Arag\u00f3n) , Zaragoza ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9nes","family":"Moln\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical School, University of P\u00e9cs , P\u00e9cs ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Russo","sequence":"additional","affiliation":[{"name":"Institute of Food Sciences, National Research Council , Avellino 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