Associations of daily sedentary time and physical activity with risk of polyvascular disease in older adults

OBJECTIVE: This study aims to explore the relationship between daily sedentary time (ST) and the risk of polyvascular disease (PVD) in older adults, as well as to assess the influence of physical activity on this association. METHODS: This cross-sectional analysis utilizes baseline data from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE), a population-based prospective cohort involving 3067 community-dwelling adults aged 50-75. Daily ST and moderate- to vigorous-intensity physical activity (MVPA) were categorized into tertiles. Polyvascular lesions in major arteries were examined using computed tomography angiography (CTA) and magnetic resonance imaging (MRI). PVD was defined as the simultaneous presence of atherosclerotic plaque or stenosis in at least two major vascular territories. Binary regression models were employed to evaluate the associations between daily ST and PVD risk, as well as the moderating effect of MVPA. RESULTS: Two thousand five hundred forty-one (82.8%) participants had atherosclerotic plaques and 412 (13.4%) participants had atherosclerotic stenosis in at least two vascular territories. Daily ST was significantly associated with an increased risk of multi-vessel atherosclerotic plaques, with this association remaining robust even after adjusting for potential confounders [OR (Ts3 vs Ts1), 1.77; 95%CI, 1.30-2.42]. The association between daily ST and multi-vessel atherosclerotic stenosis was not observed. Among different arterial territories, daily ST was associated with risk of plaque formation in extracranial [OR (Ts3 vs Ts1), 1.29; 95%CI, 1.00-1.65; p=0.047] and Ilio-femoral [OR (Ts3 vs Ts1), 1.43; 95%CI, 1.08-1.90; p=0.01] arteries, and was significantly associated with the risk of both atherosclerotic plaque [OR (Ts3 vs Ts1), 1.47; 95%CI, 1.09-1.96; p=0.01] and luminal stenosis [OR (Ts3 vs Ts1), 2.06; 95%CI, 1.03-4.11; p=0.04] in renal artery. Notably, the association between prolonged ST and multi-vessel atherosclerotic plaques persisted even among participants with the highest levels of MVPA, indicating that the benefits of physical activity may not fully offset the risks of excessive sitting. CONCLUSION: Prolonged daily ST acts as an independent risk factor for multi-vessel atherosclerotic plaques that is not completely reversible by physical activity, underscoring the importance of reducing sitting time regardless of exercise levels. Three arterial territories were affected by atherosclerosis associated with sedentary behavior, the extracranial, iliofemoral, and renal arteries.