Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries.

Autor:	Li S; National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Lear SA; Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada., Rangarajan S; Population Health Research Institute, Hamilton Health Sciences & McMaster University, Hamilton, Ontario, Canada., Hu B; National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Yin L; National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Bangdiwala SI; Population Health Research Institute, Hamilton Health Sciences & McMaster University, Hamilton, Ontario, Canada., Alhabib KF; Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia., Rosengren A; Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden., Gupta R; Eternal Heart Care Centre and Research Institute, Jawahar Circle, Jaipur, India., Mony PK; St John's Medical College & Research Institute, Bangalore, India., Wielgosz A; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Rahman O; University of Liberal Arts, Dhaka, Bangladesh., Mazapuspavina MY; Department of Primary Care Medicine, Faculty of Medicine UiTM Sg Buloh Campus, University Teknologi MARA UiTM, Malaysia., Avezum A; International Research Center, Hospital Alemão Oswaldo Cruz and UNISA, São Paulo, Brazil., Oguz A; Faculty of Medicine, Department of Internal Medicine, Istanbul Medeniyet University, Istanbul, Turkey., Yeates K; Department of Medicine, Queen's University, Kingston, Ontario, Canada., Lanas F; Universidad de La Frontera, Temuco, Chile., Dans A; Department of Medicine, University of the Philippines, Manila, Philippines., Abat MEM; Division of Adult Medicine, Department of Medicine, Philippine General Hospital, Ermita, Manila, Philippines., Yusufali A; Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, United Arab Emirates., Diaz R; Estudios Clínicos Latino América, Instituto Cardiovascular de Rosario, Rosario, Argentina., Lopez-Jaramillo P; Masira Research Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia., Leach L; University of the Western Cape, Bellville, Cape Town, South Africa., Lakshmi PVM; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India., Basiak-Rasala A; Department of Social Medicine, Wrocław Medical University, Wrocław, Poland., Iqbal R; Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan., Kelishadi R; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran., Chifamba J; Department of Biomedical Sciences Physiology Unit, University of Zimbabwe, Harare, Zimbabwe., Khatib R; Advocate Aurora Research Institute, Advocate Aurora Health, Downers Grove, Illinois.; Institute of Community and Public Health, Birzeit University, Birzeit, Palestine., Li W; National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Yusuf S; Population Health Research Institute, Hamilton Health Sciences & McMaster University, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	JAMA cardiology [JAMA Cardiol] 2022 Aug 01; Vol. 7 (8), pp. 796-807.
DOI:	10.1001/jamacardio.2022.1581
Abstrakt:	Importance: High amounts of sitting time are associated with increased risks of cardiovascular disease (CVD) and mortality in high-income countries, but it is unknown whether risks also increase in low- and middle-income countries. Objective: To investigate the association of sitting time with mortality and major CVD in countries at different economic levels using data from the Prospective Urban Rural Epidemiology study. Design, Setting, and Participants: This population-based cohort study included participants aged 35 to 70 years recruited from January 1, 2003, and followed up until August 31, 2021, in 21 high-income, middle-income, and low-income countries with a median follow-up of 11.1 years. Exposures: Daily sitting time measured using the International Physical Activity Questionnaire. Main Outcomes and Measures: The composite of all-cause mortality and major CVD (defined as cardiovascular death, myocardial infarction, stroke, or heart failure). Results: Of 105 677 participants, 61 925 (58.6%) were women, and the mean (SD) age was 50.4 (9.6) years. During a median follow-up of 11.1 (IQR, 8.6-12.2) years, 6233 deaths and 5696 major cardiovascular events (2349 myocardial infarctions, 2966 strokes, 671 heart failure, and 1792 cardiovascular deaths) were documented. Compared with the reference group (<4 hours per day of sitting), higher sitting time (≥8 hours per day) was associated with an increased risk of the composite outcome (hazard ratio [HR], 1.19; 95% CI, 1.11-1.28; Pfor trend < .001), all-cause mortality (HR, 1.20; 95% CI, 1.10-1.31; Pfor trend < .001), and major CVD (HR, 1.21; 95% CI, 1.10-1.34; Pfor trend < .001). When stratified by country income levels, the association of sitting time with the composite outcome was stronger in low-income and lower-middle-income countries (≥8 hours per day: HR, 1.29; 95% CI, 1.16-1.44) compared with high-income and upper-middle-income countries (HR, 1.08; 95% CI, 0.98-1.19; P for interaction = .02). Compared with those who reported sitting time less than 4 hours per day and high physical activity level, participants who sat for 8 or more hours per day experienced a 17% to 50% higher associated risk of the composite outcome across physical activity levels; and the risk was attenuated along with increased physical activity levels. Conclusions and Relevance: High amounts of sitting time were associated with increased risk of all-cause mortality and CVD in economically diverse settings, especially in low-income and lower-middle-income countries. Reducing sedentary time along with increasing physical activity might be an important strategy for easing the global burden of premature deaths and CVD.
Databáze:	MEDLINE
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