Abstract 17035: Dose Response Relationship Between Sedentary Time and Cardiovascular Disease Risk: A Meta-analysis
Background: Prior studies suggest that higher sedentary time is associated with greater risk for cardiovascular disease (CVD). However, the quantitative, dose-response relationship between sedentary time and CVD risk has not been reported.
Methods: PUBMED and EMBASE were searched for prospective cohort studies that evaluated the associations between sedentary time and CVD risk(coronary heart disease, stroke, CVD mortality). The categorical dose response association was evaluated by comparing the pooled hazard ratio (HR) for CVD associated with different levels of sedentary time (vs. lowest sedentary time) across studies. The continuous dose response was assessed among studies that allowed quantitative estimation of sedentary time using random effects generalized least squares spline models.
Results: Nine prospective cohort studies with 561,305 participants (54.3% women) and 24,423 incident CVD events over a median follow up of 11 years were included in the meta-analysis. In categorical analysis, compared with the lowest sedentary time category median: (2 hr/day), participants in the highest sedentary time category median: (11.5 hr/day) had an increased risk for CVD [Hazard Ratio (HR) 95% CI: 1.15 (1.11 - 1.20)]. However, there was no apparent risk associated with intermediate levels of sedentary time [Second Highest Category (median 8.1 hr/day): HR (95%CI)= 0.99 (0.96 - 1.03);Third Highest Category (median 5.1 hr/day): HR (95%CI)= 1.06 (0.98 - 1.05)]. In continuous analyses, there was a non-linear relationship between sedentary time and CVD (p-value for non-linearity: 0.0001), with an increased risk for CVD observed for more than 10 hours/day of sedentary time [Pooled HR: 1.07 (1.00 to 1.14), Figure].
Conclusion: CVD risk associated with sedentary time is non-linear with an increased risk only at very high levels (> 10 hr/day). These findings could have implications for future guideline recommendations regarding the risks related to sedentary behavior.
Author Disclosures: U.I. Salahuddin: None. A. Pandey: None. C.R. Ayers: None. J. Kulinski: None. S. Garg: None. D.J. Kumbhani: None. J.A. de Lemos: Consultant/Advisory Board; Modest; Novo Nordisc, St. Jude Medical. Research Grant; Significant; Roche Diagnostics, Abbott Diagnostics. J.D. Berry: None.
- © 2015 by American Heart Association, Inc.