Background: The association between sedentary behavior (SB) and cardiometabolic risk may differ by SB domain and context. Nonoccupational SB is particularly important because it is discretionary and more amenable to change. This study estimated associations of nonoccupational SB contexts with hypertension (HTN) and diabetes mellitus (DM).
Methods: A total of 3370 middle-aged adults (50.1 ± 3.6 years; 56% F) from the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Cross-sectional and 5-year prospective associations between self-report total SB and 6 context-specific SBs (television-TV, computer, transportation, phone, music, and paperwork) with HTN and DM were tested using logistic regression. Fully adjusted models controlled for sociodemographic variables, body mass index, and self-report moderate-vigorous intensity physical activity.
Results: Prevalences of HTN and DM at baseline were 48% (1618 cases) and 10% (320 cases), respectively. Each hour per day of total-SB was cross-sectionally associated with HTN (OR: 1.03, 95% CI, 1.01-1.05) but not DM, with nonsignificant prospective associations for HTN and DM. Of the context-specific SBs, only TV-SB was significantly associated with HTN or DM. Each hour of TV-SB was cross-sectionally associated with HTN (OR: 1.09, 95% CI, 1.03-1.15) and DM (OR: 1.18, 95% CI, 1.09-1.29), and prospectively with HTN (OR: 1.14, 95% CI, 1.04-1.26) but not DM.
Conclusion: When comparing total-SB and the 6 context-specific SBs, TV-SB was most robustly associated with HTN. The findings were less clear for DM. Behavior change strategies that target TV-SB reduction may be effective at reducing HTN risk in middle-aged adults.
Keywords: cardiometabolic risk; diabetes; hypertension; observational cohort; sedentary behavior.
The link between sedentary behavior (SB) and health risks may differ by the type (context) of SB. Nonwork-related SB is important because it is discretionary and can more easily be changed. This study looked at associations of nonwork-related SB contexts with high blood pressure (BP) and diabetes in 3370 middle-aged adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Cross-sectional and 5-year prospective associations between total SB and 6 context-specific SBs (television—TV, computer, transportation, phone, music, and paperwork) with high BP and diabetes were tested. Our analyses controlled for sociodemographic variables, body mass index, and physical activity. At baseline, 48% of participants had high BP and 10% had diabetes. At baseline, each hour per day of total-SB was associated with high BP. Additionally, each hour of TV-SB was associated with high BP and diabetes. TV-SB also predicted high BP 5 years later. When comparing total-SB and the 6 context-specific SBs, TV-SB was most strongly associated with high BP. The findings were less clear for diabetes. Behavior change strategies that target TV-SB reduction may be effective at reducing high BP risk in middle-aged adults.
© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.