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

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