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Sedentary Behavior and Cardiovascular Disease in Older Women: The OPACH Study
Open accessAbstract
Background: Evidence that higher sedentary time is associated with higher risk for cardiovascular disease (CVD) is based mainly on self-reported measures. Few studies have examined whether patterns of sedentary time are associated with higher risk for CVD. Methods: Women from the OPACH Study (Objective Physical Activity and Cardiovascular Health; n=5638, aged 63–97 years, mean age 79±7 years) with no history of myocardial infarction or stroke wore accelerometers for 4 to 7 days and were followed up for up to 4.9 years for CVD events. Average daily sedentary time and mean sedentary bout duration were the exposures of interest. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs for CVD using models adjusted for covariates and subsequently adjusted for potential mediators (body mass index, diabetes mellitus, hypertension, and CVD risk biomarkers [fasting glucose, high-density lipoprotein, triglycerides, and systolic blood pressure]). Restricted cubic spline regression characterized dose-response relationships. Results: There were 545 CVD events during 19 350 person-years. With adjustment for covariates, women in the highest (≈11 h/d or more) versus the lowest (≈9 h/d or less) quartile of sedentary time had higher risk for CVD (HR, 1.62; 95% CI, 1.21–2.17; P trend <0.001). Further adjustment for potential mediators attenuated but did not eliminate significance of these associations ( P trend <0.05, each). Longer versus shorter mean sedentary bout duration was associated with higher risks for CVD (HR, 1.54; 95% CI, 1.27–2.02; P trend=0.003) after adjustment for covariates. Additional adjustment for CVD risk biomarkers attenuated associations, resulting in a quartile 4 versus quartile 1 HR of 1.36 (95% CI, 1.01–1.83; P trend=0.10). Dose-response associations of sedentary time and bout duration with CVD were linear ( P nonlinear >0.05, each). Women jointly classified as having both high sedentary time and long bout durations had significantly higher risk for CVD (HR, 1.34; 95% CI, 1.08–1.65) than women with low sedentary time and short bout duration. All analyses were repeated for incident coronary heart disease (myocardial infarction or CVD death), and associations were similar, with notably stronger HRs. Conclusions: Both high sedentary time and long mean bout durations were associated in a dose-response manner with increased CVD risk in older women, which suggests that efforts to reduce CVD burden might benefit from addressing either or both components of sedentary behavior.
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“Prolonged sedentary time is also associated with a 12% higher risk of incidental cardiovascular disease (CVD) independent of physical activity levels [1].”
From Feasibility and Preliminary Efficacy of a “Sit Less” Program Leveraging Fitbit Tracking and Tailored Text Messages in Cardiometabolic Disease: Findings From 2 Parallel Randomized Controlled Trials in Coronary Artery Disease and Type 2 Diabetes (2026) · cites this paper as [1]
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“Sedentary behavior is a strong modifiable risk factor for cardiometabolic disease [1,2].”
From Feasibility and Preliminary Efficacy of a “Sit Less” Program Leveraging Fitbit Tracking and Tailored Text Messages in Cardiometabolic Disease: Findings From 2 Parallel Randomized Controlled Trials in Coronary Artery Disease and Type 2 Diabetes (2026) · cites this paper as [1]
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“Emerging evidence suggests that physical activity attenuates cardiometabolic risk but does not eliminate the increased risk associated with high sedentary time [1,6].”
From Feasibility and Preliminary Efficacy of a “Sit Less” Program Leveraging Fitbit Tracking and Tailored Text Messages in Cardiometabolic Disease: Findings From 2 Parallel Randomized Controlled Trials in Coronary Artery Disease and Type 2 Diabetes (2026) · cites this paper as [1]
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Metadata
- Authors
- Bellettiere, J., LaMonte, M. J., Evenson, K. R., Rillamas-Sun, E., Kerr, J., Lee, I.-M., Di, C., Rosenberg, D. E., Stefanick, M. L., Buchner, D. M., Hovell, M. F., LaCroix, A. Z., Rossouw, J., Ludlam, S., Burwen, D., McGowan, J., Ford, L., Geller, N., Anderson, G., Prentice, R., Kooperberg, C., Manson, J. E., Howard, B. V., Jackson, R., Thomson, C. A., Wactawski-Wende, J., Limacher, M., Wallace, R., Kuller, L., Shumaker, S., & Shumaker, S.
- Affiliations
- San Diego State University (US)
- University at Buffalo, State University of New York (US)
- University of North Carolina at Chapel Hill (US)
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (E.R.-S., C.D.).
- University of California San Diego (US)
- Brigham and Women's Hospital (US)
- Fred Hutch Cancer Center (US)
- Group Health Cooperative (US)
- Stanford Medicine (US)
- University of Illinois at Urbana-Champaign, (D.M.B.).
- ORCID
- Bellettiere, John
- LaMonte, Michael J.
- Evenson, Kelly R.
- Kerr, Jacqueline
- Lee, I-Min
- Di, Chongzhi
- Rosenberg, Dori E.
- Stefanick, Marcia L.
- Hovell, Melbourne F.
- LaCroix, Andrea Z.
- Rossouw, Jacques
- Geller, Nancy
- Anderson, Garnet
- Prentice, Ross
- Kooperberg, Charles
- Manson, JoAnn E.
- Howard, Barbara V.
- Thomson, Cynthia A.
- Limacher, Marian
- Wallace, Robert
- Kuller, Lewis
- Venue
- Circulation
- Published
- 2019-02-19
- Volume
- 139
- Issue
- 8
- Pages
- 1036-1046
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC6481298
- OpenAlex
- W2916721746
- Cited by
- 252
- References
- 50
- Citations by year
- 2026: 17 · 2025: 25 · 2024: 48 · 2023: 50 · 2022: 45 · 2021: 37 · 2020: 24 · 2019: 6
- FWCI
- 19.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services (HHSN268201600002 C, HHSN268201600018 C, HHSN268201600003C, TL1TR001443, HHSN268201600004 C, HHSN268201600001 C)
- National Institutes of Health (HHSN268201600018C, TL1TR001443, HHSN268201600003C, HHSN268201600004C, HHSN268201600001C, HHSN268201600002C)
- National Institute on Aging (P01AG052352, U19AG066567)
- National Heart, Lung, and Blood Institute (HHSN268201600018C, HHSN268201600004C, HHSN268201600001C, K23HL119352, HL105065, R01HL105065, HHSN268201600003C, HHSN268201600002C, RO1 HL105065, R01HL130483, T32HL079891)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- sedentary behavior, cardiovascular disease, older women, sedentary bout duration, accelerometer-measured sedentary time, cardiovascular risk factors, dose-response relationship, myocardial infarction, stroke, physical activity, sex differences in cardiovascular risk, body mass index, diabetes mellitus, hypertension, dyslipidemia
- MeSH terms
- Healthy Lifestyle, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Health Status, Humans, Middle Aged, Prospective Studies, Risk Factors, Time Factors, United States, Exercise, Incidence, Women's Health, Risk Assessment, Risk Reduction Behavior, Sedentary Behavior
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