Screen-based entertainment time, all-cause mortality, and cardiovascular events population-based study with ongoing mortality and hospital events follow-up

Stamatakis, Emmanuel, Hamer, Mark and Dunstan, David W. (2011) Screen-based entertainment time, all-cause mortality, and cardiovascular events population-based study with ongoing mortality and hospital events follow-up. Journal of the American College of Cardiology, 57 3: 292-299. doi:10.1016/j.jacc.2010.05.065


Author Stamatakis, Emmanuel
Hamer, Mark
Dunstan, David W.
Title Screen-based entertainment time, all-cause mortality, and cardiovascular events population-based study with ongoing mortality and hospital events follow-up
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
1558-3597
Publication date 2011-01
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.jacc.2010.05.065
Volume 57
Issue 3
Start page 292
End page 299
Total pages 8
Place of publication San Diego CA, United States
Publisher Elsevier
Collection year 2012
Language eng
Formatted abstract
Objectives
The aim of this study was to examine the independent relationships of television viewing or other screen-based entertainment (“screen time”) with all-cause mortality and clinically confirmed cardiovascular disease (CVD) events. A secondary objective was to examine the extent to which metabolic (body mass index, high-density lipoprotein and total cholesterol) and inflammatory (C-reactive protein) markers mediate the relationship between screen time and CVD events.

Background

Although some evidence suggests that prolonged sitting is linked to CVD risk factor development regardless of physical activity participation, studies with hard outcomes are scarce.

Methods

A population sample of 4,512 (1,945 men) Scottish Health Survey 2003 respondents (≥35 years) were followed up to 2007 for all-cause mortality and CVD events (fatal and nonfatal combined). Main exposures were interviewer-assessed screen time (<2 h/day; 2 to <4 h/day; and ≥4 h/day) and moderate to vigorous intensity physical activity.

Results
Two hundred fifteen CVD events and 325 any-cause deaths occurred during 19,364 follow-up person-years. The covariable (age, sex, ethnicity, obesity, smoking, social class, long-standing illness, marital status, diabetes, hypertension)-adjusted hazard ratio (HR) for all-cause mortality was 1.52 (95% confidence interval [CI]: 1.06 to 2.16) and for CVD events was 2.30 (95% CI: 1.33 to 3.96) for participants engaging in ≥4 h/day of screen time relative to <2 h/day. Adjusting for physical activity attenuated these associations only slightly (all-cause mortality: HR: 1.48, 95% CI: 1.04 to 2.13; CVD events: HR: 2.25, 95% CI: 1.30 to 3.89). Exclusion of participants with CVD events in the first 2 years of follow-up and previous cancer registrations did not change these results appreciably. Approximately 25% of the association between screen time and CVD events was explained collectively by C-reactive protein, body mass index, and high-density lipoprotein cholesterol.

Conclusions

Recreational sitting, as reflected by television/screen viewing time, is related to raised mortality and CVD risk regardless of physical activity participation. Inflammatory and metabolic risk factors partly explain this relationship.
Keyword Mortality
Physical activity
Sedentary behavior
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 11 January 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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Created: Sun, 13 Feb 2011, 00:01:31 EST