Total sitting time and risk of myocardial infarction, coronary heart disease and all-cause mortality in a prospective cohort of Danish adults.
BACKGROUND
Evidence suggests that sitting time is adversely associated with health risks. However, previous epidemiological studies have mainly addressed mortality whereas little is known of the risk of coronary heart disease. This study aimed to investigate total sitting time and risk of myocardial infarction, coronary heart disease incidence and all-cause mortality.


METHODS
In the Danish Health Examination Survey (DANHES) conducted in 2007-2008 we tested the hypothesis that a higher amount of daily total sitting time is associated with greater risk of myocardial infarction, coronary heart disease and all-cause mortality. The study population consisted of 71,363 men and women aged 18-99 years without coronary heart disease. Participants were followed for myocardial infarction, coronary heart disease and mortality in national registers to August 10, 2012. Cox regression analyses were performed with adjustment for potential confounders and multiple imputation for missing values.


RESULTS
During a mean follow-up period of 5.4 years 358 incident cases of myocardial infarction, 1,446 of coronary heart disease, and 1,074 deaths from all causes were registered. The hazard ratios associated with 10 or more hours of daily sitting compared to less than 6 hours were 1.38 (95% CI: 1.01, 1.88) for myocardial infarction, 1.07 (95% CI: 0.91, 1.27) for coronary heart disease and 1.31 (95% CI: 1.09, 1.57). Compared to sitting less than 6 hours per day and being physically active in leisure time, the hazard ratios of sitting more than 10 hours per day and also being physically inactive in leisure time were 1.80 (95% CI: 1.15, 2.82) for myocardial infarction, 1.42 (95% CI: 1.11, 1.81) for coronary heart disease, and 2.29 (95% CI: 1.82, 2.89) for all-cause mortality.


CONCLUSIONS
The results suggest that a higher amount of daily total sitting time is associated with all-cause mortality, particularly among inactive adults. In relation to coronary heart, disease results were less clear. This paper adds new evidence to the limited data on the evidence of sitting time and cardiovascular disease and mortality.
National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen 1353, Denmark. cbj@niph.dk.
Christina
C
Bjørk Petersen
Adrian
A
Bauman
Morten
M
Grønbæk
Jørn
J
Wulff Helge
Lau Caspar
LC
Thygesen
Janne S
JS
Tolstrup
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology*; D003718:Denmark; D005260:Female; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009043:Motor Activity; D009203:Myocardial Infarction / Q000453:epidemiology*; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D055815:Young Adult
D014280:Triglycerides; D002784:Cholesterol