Sedentary Behavior and Cardiovascular Disease in Older Women

作者：John Bellettiere, Michael J. LaMonte, Kelly R. Evenson, Eileen Rillamas‐Sun, Jacqueline Kerr, I‐Min Lee, Chongzhi Di, Dori E. Rosenberg, Marcia L. Stefanick, David M. Büchner, Melbourne F. Hovell, Andrea Z. LaCroix, Jacques E. Rossouw, Shari Ludlam, Dale R. Burwen, Joan McGowan, Leslie Ford, Nancy L. Geller, Garnet L. Anderson, Ross Prentice, Charles Kooperberg, JoAnn E. Manson, Barbara V. Howard, Rebecca D. Jackson, Cynthia A. Thomson, Jean Wactawski‐Wende, Marian C. Limacher, R Wallace, Lewis Kuller, Sally A. Shumaker, Sally A. Shumaker · 发表于：Circulation · 年份：2019 · DOI：10.1161/circulationaha.118.035312 · 被引用次数：266 · 研究领域：Physical Activity and Health、Cardiovascular and exercise physiology、Health Promotion and Cardiovascular Prevention

Background: Evidence that higher sedentary time is associated with higher risk for cardiovascular disease (CVD) is based mainly on self-reported measures. Few studies have examined whether patterns of sedentary time are associated with higher risk for CVD. Methods: Women from the Objective Physical Activity and Cardiovascular Health (OPACH) Study (n=5638, aged 63-97, mean age=79±7) with no history of myocardial infarction (MI) or stroke wore accelerometers for 4-to-7 days and were followed for up to 4.9 years for CVD events. Average daily sedentary time and mean sedentary bout duration were the exposures of interest. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for CVD using models adjusted for covariates and subsequently adjusted for potential mediators (body mass index (BMI), diabetes, hypertension, and CVD-risk biomarkers [fasting glucose, high-density lipoprotein, triglycerides, and systolic blood pressure]). Restricted cubic spline regression characterized dose-response relationships. Results: There were 545 CVD events during 19,350 person-years. Adjusting for covariates, women in the highest (≥ ~11 hr/day) vs. the lowest (≤ ~9 hr/day) quartile of sedentary time had higher risk for CVD (HR=1.62; CI=1.21-2.17; p-trend <0.001). Further adjustment for potential mediators attenuated but did not eliminate significance of these associations (p-trend<.05, each). Longer vs. shorter mean bout duration was associated with higher risks for CV...