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Forouzanfar MH, et al. Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990\u20132015. JAMA. 2017;317:165.","DOI":"10.1001\/jama.2016.19043"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Bucholz EM, Gooding HC, De Ferranti SD. Awareness of Cardiovascular Risk Factors in U.S. Young Adults Aged 18\u201339 Years. Am J Prev Med. 2018;54:e67\u201377.","DOI":"10.1016\/j.amepre.2018.01.022"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Li Y, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020:m997. https:\/\/doi.org\/10.1136\/bmj.m997.","DOI":"10.1136\/bmj.m997"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Yang W, et al. Serum Lipids and Lipoproteins in Chinese Men and Women. Circulation. 2012;125:2212\u201321.","DOI":"10.1161\/CIRCULATIONAHA.111.065904"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Pescatello LS, et al. Physical Activity to Prevent and Treat Hypertension: A Systematic Review. Med Sci Sports Exerc. 2019;51:1314\u201323.","DOI":"10.1249\/MSS.0000000000001943"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Bull FC, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54:1451\u201362.","DOI":"10.1136\/bjsports-2020-102955"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Bell AC, Richards J, Zakrzewski-Fruer JK, Smith LR, Bailey DP. Sedentary Behaviour\u2014A Target for the Prevention and Management of Cardiovascular Disease. IJERPH. 2022;20:532.","DOI":"10.3390\/ijerph20010532"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Garcia L, et al. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose\u2013response meta-analysis of large prospective studies. Br J Sports Med. 2023;57:979\u201389.","DOI":"10.1136\/bjsports-2022-105669"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Cuthbertson CC, et al. Associations of Leisure-Time Physical Activity and Television Viewing With Life Expectancy Free of Nonfatal Cardiovascular Disease: The ARIC Study. JAHA. 2019;8:e012657.","DOI":"10.1161\/JAHA.119.012657"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Bennett DA, et al. Association of Physical Activity With Risk of Major Cardiovascular Diseases in Chinese Men and Women. JAMA Cardiol. 2017;2:1349.","DOI":"10.1001\/jamacardio.2017.4069"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Tu R, et al. Physical activity attenuated association of air pollution with estimated 10-year atherosclerotic cardiovascular disease risk in a large rural Chinese adult population: A cross-sectional study. Environ Int. 2020;140:105819.","DOI":"10.1016\/j.envint.2020.105819"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Li C, et al. Leisure-Time Physical Activity Among Chinese Adults \u2014 China, 2015. China CDC Wkly. 2020;2:671\u20137.","DOI":"10.46234\/ccdcw2020.187"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Deng MG, Nie JQ, Li YY, Yu X, Zhang ZJ. Higher HEI-2015 Scores Are Associated with Lower Risk of Sleep Disorder: Results from a Nationally Representative Survey of United States Adults. Nutrients. 2022;14:873.","DOI":"10.3390\/nu14040873"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Wang YH, et al. Association of Longitudinal Patterns of Habitual Sleep Duration With Risk of Cardiovascular Events and All-Cause Mortality. JAMA Netw Open. 2020;3:e205246.","DOI":"10.1001\/jamanetworkopen.2020.5246"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Ramos AR, et al. Sleep Patterns and Hypertension Using Actigraphy in the Hispanic Community Health Study\/Study of Latinos. Chest. 2018;153:87\u201393.","DOI":"10.1016\/j.chest.2017.09.028"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Johnson DA, et al. Association Between Sleep Apnea and Blood Pressure Control Among Blacks: Jackson Heart Sleep Study. Circulation. 2019;139:1275\u201384.","DOI":"10.1161\/CIRCULATIONAHA.118.036675"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Dong L, Martinez AJ, Buysse DJ, Harvey AG. A composite measure of sleep health predicts concurrent mental and physical health outcomes in adolescents prone to eveningness. Sleep Health. 2019;5:166\u201374.","DOI":"10.1016\/j.sleh.2018.11.009"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Hu S, Lan T, Wang Y, Ren L. Individual Insomnia Symptom and Increased Hazard Risk of Cardiocerebral Vascular Diseases: A Meta-Analysis. Front Psychiatry. 2021;12:654719.","DOI":"10.3389\/fpsyt.2021.654719"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Li L, et al. Prevalence of Poor Sleep Quality in Patients With Hypertension in China: A Meta-analysis of Comparative Studies and Epidemiological Surveys. Front Psychiatry. 2020;11:591.","DOI":"10.3389\/fpsyt.2020.00591"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Wang J, et al. Prevalence of sleep disturbances and associated factors among Chinese residents: A web-based empirical survey of 2019. J Glob Health. 2023;13:04071.","DOI":"10.7189\/jogh.13.04071"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Erqou S, et al. Particulate Matter Air Pollution and Racial Differences in Cardiovascular Disease Risk. ATVB. 2018;38:935\u201342.","DOI":"10.1161\/ATVBAHA.117.310305"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Chen F, et al. Impact of exposure to noise on the risk of hypertension: A systematic review and meta-analysis of cohort studies. Environ Res. 2021;195:110813.","DOI":"10.1016\/j.envres.2021.110813"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Kourieh A, et al. Incident hypertension in relation to aircraft noise exposure: results of the DEBATS longitudinal study in France. Occup Environ Med. 2022;79:268\u201376.","DOI":"10.1136\/oemed-2021-107921"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Tsunetsugu Y, Park BJ, Miyazaki Y. Trends in research related to \u201cShinrin-yoku\u201d (taking in the forest atmosphere or forest bathing) in Japan. Environ Health Prev Med. 2010;15:27\u201337.","DOI":"10.1007\/s12199-009-0091-z"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environ Health Prev Med. 2010;15:18\u201326.","DOI":"10.1007\/s12199-009-0086-9"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Ochiai H, et al. Physiological and Psychological Effects of a Forest Therapy Program on Middle-Aged Females. IJERPH. 2015;12:15222\u201332.","DOI":"10.3390\/ijerph121214984"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Moleman P. Urinary Excretion of Catecholamines and Their Metabolites in Relation to Circulating Catecholamines: Six-Hour Infusion of Epinephrine and Norepinephrine in Healthy Volunteers. Arch Gen Psychiatry. 1992;49:568.","DOI":"10.1001\/archpsyc.1992.01820070062009"},{"key":"28","unstructured":"28. Li Q, et al. A day trip to a forest park increases human natural killer activity and the expression of anti-cancer proteins in male subjects. J Biol Regul Homeost Agents. 2010;24:157\u201365."},{"key":"29","unstructured":"29. Li Q, et al. A forest bathing trip increases human natural killer activity and expression of anti-cancer proteins in female subjects. J Biol Regul Homeost Agents. 2008;22:45\u201355."},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. Li Q, et al. Effects of Forest Bathing on Cardiovascular and Metabolic Parameters in Middle-Aged Males. Evid Based Complement Alternat Med. 2016;2016:2587381.","DOI":"10.1155\/2016\/2587381"},{"key":"31","doi-asserted-by":"crossref","unstructured":"31. Ideno Y, et al. Blood pressure-lowering effect of Shinrin-yoku (Forest bathing): a systematic review and meta-analysis. BMC Complement Altern Med. 2017;17:409.","DOI":"10.1186\/s12906-017-1912-z"},{"key":"32","doi-asserted-by":"publisher","unstructured":"32. Dai X, et al. Frontiers | Forest bathing enhances sleep, mood, and immunity: insights from low-latitude evergreen broad-leaved forests. https:\/\/doi.org\/10.3389\/ffgc.2025.1619569.","DOI":"10.3389\/ffgc.2025.1619569"},{"key":"33","doi-asserted-by":"crossref","unstructured":"33. Cohen S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress. J Health Soc Behav. 1983;24:385.","DOI":"10.2307\/2136404"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Lira FT, White MJ, Finch AJ. Anxiety and mood states in delinquent adolescents. J Pers Assess. 1977;41:532\u20136.","DOI":"10.1207\/s15327752jpa4105_12"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35. Cui WQ, et al. A Resting-State Functional Magnetic Resonance Imaging Study of Abnormal Frontoparietal Network Function in Migraine without Aura. Med Sci Monit. 2022;28:e934975.","DOI":"10.12659\/MSM.934975"},{"key":"36","doi-asserted-by":"crossref","unstructured":"36. Yin J, et al. Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. JAHA. 2017;6:e005947.","DOI":"10.1161\/JAHA.117.005947"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Stansfield BK, Ingram DA. Clinical significance of monocyte heterogeneity. Clin Transl Med. 2015;4:5.","DOI":"10.1186\/s40169-014-0040-3"},{"key":"38","doi-asserted-by":"crossref","unstructured":"38. Andersen CL, et al. Prevalence and clinical significance of neutropenia discovered in routine complete blood cell counts: a longitudinal study. J Intern Med. 2016;279:566\u201375.","DOI":"10.1111\/joim.12467"},{"key":"39","doi-asserted-by":"crossref","unstructured":"39. Karakonstantis S, Gryllou N, Papazoglou G, Lydakis C. Eosinophil count (EC) as a diagnostic and prognostic marker for infection in the internal medicine department setting. Rom J Intern Med. 2019;57:166\u201374.","DOI":"10.2478\/rjim-2018-0039"},{"key":"40","doi-asserted-by":"crossref","unstructured":"40. Lippi G, Henry BM, Mattiuzzi C. Red blood cell distribution width (RDW) reflects disease severity in patients with carbon monoxide poisoning: systematic literature review and meta-analysis. Scand J Clin Lab Invest. 2024;84:79\u201383.","DOI":"10.1080\/00365513.2024.2332998"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41. Ligi D, et al. Platelet distribution width (PDW) as a significant correlate of COVID-19 infection severity and mortality. Clin Chem Lab Med. 2024;62:385\u201395.","DOI":"10.1515\/cclm-2023-0625"},{"key":"42","doi-asserted-by":"crossref","unstructured":"42. Lloyd-Jones DM, et al. Life\u2019s Essential 8: Updating and Enhancing the American Heart Association\u2019s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146:e18\u201343.","DOI":"10.1161\/CIR.0000000000001078"},{"key":"43","doi-asserted-by":"crossref","unstructured":"43. Aberra T, et al. The association between triglycerides and incident cardiovascular disease: What is \u2018optimal\u2019? J Clin Lipidol. 2020;14:438\u201347.e3.","DOI":"10.1016\/j.jacl.2020.04.009"},{"key":"44","doi-asserted-by":"crossref","unstructured":"44. Kronenberg F, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;43:3925\u201346.","DOI":"10.1093\/eurheartj\/ehac361"},{"key":"45","unstructured":"45. Chen F, Xia J. <i>Clinical Trial Statistics<\/i>. People\u2019s Medical Publishing House: Beijing, 2018."},{"key":"46","doi-asserted-by":"crossref","unstructured":"46. Li Q, et al. Effects of forest bathing (shinrin-yoku) on serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males. Environ Health Prev Med. 2022;27:44.","DOI":"10.1265\/ehpm.22-00136"},{"key":"47","doi-asserted-by":"crossref","unstructured":"47. Fi\u013eo P, Janou\u0161ek O. Differences in the Course of Physiological Functions and in Subjective Evaluations in Connection With Listening to the Sound of a Chainsaw and to the Sounds of a Forest. Front Psychol. 2022;13:775173.","DOI":"10.3389\/fpsyg.2022.775173"},{"key":"48","doi-asserted-by":"crossref","unstructured":"48. Lee J, et al. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health. 2011;125:93\u2013100.","DOI":"10.1016\/j.puhe.2010.09.005"},{"key":"49","doi-asserted-by":"crossref","unstructured":"49. Li A, et al. Therapeutic effects of forest bathing on older adult patients with essential hypertension: evidence from a subtropical evergreen broad-leaved forest. 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