The World Health Organization guidelines for physical activity and sedentary behavior recognize the impact of prolonged sedentary behavior on the risk of cardiovascular disease in both adults and children, noting that higher levels of sedentary behavior are associated with adverse effects on mortality. mortality from cardiovascular disease and cancer. mortality and incidence of cardiovascular disease, type 2 diabetes and cancer. Although increased levels of physical activity are generally required to improve cardiovascular disease risk in the general population, a 2019 systematic review concluded that higher levels of total daily sitting time were associated with an increased risk of cardiovascular disease and diabetes, regardless of activity. However, the evidence to date that sedentary behavior is associated with an increased risk of cardiovascular disease comes largely from high-income countries and therefore underscores the need to consider generalizing these findings to low- and middle-income countries. In the present study, the Chinese team sought to determine the association between self-reported seating time and cardiovascular disease risk in countries with different income levels, using data from PURE, a large-scale, prospective cohort study that recruited people up to 70 years old. from 21 countries in Africa, Asia, Europe, the Middle East and North and South America. Information about sitting time and total physical activity was collected using a validated questionnaire and daily sitting time was categorized into four groups: < 4 ώρες/ημέρα. 4 έως 6 ώρες/ημέρα. 6 έως 8 ώρες/ημέρα και > 8 hours / day. For the current analysis, the primary outcome of interest was the assessment of cardiovascular disease risk, based on a complex mortality from all causes and major cardiovascular events (cardiovascular mortality, non-fatal myocardial infarction while stroke, or stroke). secondary outcomes the individual components of the composite material were examined. Risk of cardiovascular disease and sitting time A total of 105,677 people with a mean age of 50.4 years (58.6% women) were included and followed for an average of 11.1 years. At first the median sitting time was 4 hours but ranged from 2.6 to 7.3 hours. Overall, 13.7% of people came from a high-income country, 47.2% from a low-middle-income country and 9.8% from a low-income country. During the follow-up period, there were 6,233 deaths and 5,696 major cardiovascular events. Using a sitting time of less than 4 hours as a reference point, the fully adjusted risk of the composite effect was higher, not surprising, for those sitting for> 8 hours (risk ratio, HR = 1.19, 95% CI 1.11 – 1.28, p < 0,01) και αυτός ο κίνδυνος ήταν σημαντικά αυξημένος πάνω από 6 ώρες. Παρόμοιος αυξημένος κίνδυνος όταν κάθεστε για > 8 hours was also observed for mortality from all causes (HR = 1.20, 95% CI 1.10 – 1.31, P <0.01) and for each of the individual components of the primary composite. Interestingly, when researchers stratified data by country income level, the correlation between sedentary time and composite outcome was greater for people from low / low middle income countries compared to high income / upper middle income countries for seating periods. over 8 hours (HR = 1.29, 95% CI 1.16 – 1.44, vs HR = 1.08, 95% CI 0.98 – 1.19, low-income versus high-income countries). The authors conclude that while the data confirmed previous studies on the side effects of prolonged sedentary lifestyle, this was more evident in low-middle and low-income countries. They suggested that increased physical activity represented an important strategy to reduce the risk of cardiovascular disease due to prolonged sedentary posture. CitationLi S et al. Association of sedentary living time with mortality and cardiovascular events in high-income, middle-income and low-income countries JAMA Cardiol 2022.
