The impact of sedentary behavior patterns on carotid atherosclerotic burden: Implications from the Corinthia epidemiological study


      • Physical activity is associated with a reduction of cardiovascular events.
      • Few data exist about the association of sedentary behavior with atherosclerosis.
      • Association between hypertension prevalence and increasing TV-viewing-time.
      • TV-viewing-time was associated with increased mean cIMT and carotid atheromatic plaque.
      • Sedentary behavior may provoke atherosclerotic progression.


      Background and aims

      Sedentary lifestyle, unlike leisure time physical activity (PA), is associated with atherosclerosis progression. Regarding the interrelationship between television watching, as a sedentary behavior pattern, and cardiovascular disease burden, few data exist.


      In this cross-sectional epidemiological study based on 2043 inhabitants of the Corinthia region, in Greece, ultrasonography was used to measure carotid intima-media thickness (IMT) in both carotid arteries. The average (meanIMT) and maximum thickness (maxIMT) were determined as representative values of subclinical atherosclerosis. We evaluated PA using the self-reported International Physical Activity Questionnaire (IPAQ). Based on specific questions, the average hours per week spent on watching television (TV), videos or DVD was calculated for each participant.


      According to TV viewing time, subjects were categorized into the low (≤7 h/week), moderate (7˃ TV hours/week ≤21) and high (˃21 h/week) TV viewing time groups. Prevalence of carotid atheromatic plaque was lower in the low TV viewing time group compared to the moderate and high TV viewing time groups (p = 0.02). TV viewing time was associated with increased carotid IMT (p = 0.03) and the prevalence of carotid atheromatic plaque (p = 0.02), even after adjustment for age, body mass index, cardiovascular risk factors or history of cardiovascular disease. Subjects in the high TV viewing time group have 80% increase odds of carotid atheromatic plaque compared to patients categorized in the low TV viewing time group (p = 0.01).


      The present findings have important public health implications, providing a better understanding of the components of sedentary behavior that are associated with atherosclerotic progression.

      Graphical abstract


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