scholarly journals Relationship between risk factor control and vascular events in the SAMMPRIS trial

Neurology ◽  
2016 ◽  
Vol 88 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Tanya N. Turan ◽  
Azhar Nizam ◽  
Michael J. Lynn ◽  
Brent M. Egan ◽  
Ngoc-Anh Le ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Pressure ◽  
Risk Factor ◽  
Recurrent Stroke ◽  
Density Lipoprotein ◽  
Vascular Events ◽  
Risk Factor Control

Objective:The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study is the first stroke prevention trial to include protocol-driven intensive management of multiple risk factors. In this prespecified analysis, we aimed to investigate the relationship between risk factor control during follow-up and outcome of patients in the medical arm of SAMMPRIS.Methods:Data from SAMMPRIS participants in the medical arm (n = 227) were analyzed. Risk factors were recorded at baseline, 30 days, 4 months, and then every 4 months for a mean follow-up of 32 months. For each patient, values for all risk factor measures were averaged and dichotomized as in or out of target.Results:Participants who were out of target for systolic blood pressure and physical activity, as well as those with higher mean low-density lipoprotein cholesterol and non–high-density lipoprotein, were more likely to have a recurrent vascular event (stroke, myocardial infarction, or vascular death) at 3 years compared to those who had good risk factor control. In the multivariable analysis, greater physical activity decreased the likelihood of a recurrent stroke, myocardial infarction, or vascular death (odds ratio 0.6, confidence interval 0.4–0.8).Conclusions:Raised blood pressure, cholesterol, and physical inactivity should be aggressively treated in patients with intracranial atherosclerosis to prevent future vascular events. Physical activity, which has not received attention in stroke prevention trials, was the strongest predictor of a good outcome in the medical arm in SAMMPRIS.ClinicalTrials.gov identifier:NCT00576693.

Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Wienbergen ◽  
A Fach ◽  
S Meyer ◽  
J Schmucker ◽  
R Osteresch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Prevention Program ◽  
Study Endpoint ◽  
Funding Source ◽  
Risk Factor Control ◽  
One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after >24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p<0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p<0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p<0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after >24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

Program of Rehabilitative Exercise and Education to Avert Vascular Events After Non-Disabling Stroke or Transient Ischemic Attack (PREVENT Trial): A Randomized Controlled Trial

2021 ◽  
pp. 154596832110603
Author(s):  
MacKay-Lyons Marilyn ◽  
Gubitz Gordon ◽  
Phillips Stephen ◽  
Giacomantonio Nicholas ◽  
Firth Wanda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Post Intervention ◽  
Vascular Events ◽  
Randomized Controlled ◽  
Ischemic Attack

Background Non-disabling stroke (NDS) and transient ischemic attack (TIA) herald the possibility of future, more debilitating vascular events. Evidence is conflicting about potency of exercise and education in reducing risk factors for second stroke. Methods Three-site, single-blinded, randomized controlled trial with 184 participants <3 months of NDS or TIA (mean age, 65 years; 66% male) randomized to usual care (UC) or UC + 12-week program of exercise and education (PREVENT). Primary (resting systolic blood pressure) and secondary outcomes (diastolic blood pressure [DBPrest], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], TC/HDL, triglycerides, fasting glucose, and body mass index) were assessed at baseline, post-intervention, and 6- and 12-month follow-up. Peak oxygen consumption (VO2peak) was measured at baseline, post-intervention, 12-month assessments. Results Significant between-group differences at post-intervention favored PREVENT group over UC: DBPrest (mean difference [MD]: −3.2 mmHg, 95% confidence interval [CI]: −6.3, −.2, P = .04) and LDL-C (MD: −.31 mmol/L, 95% CI: −.42, −.20, P = .02). Trends of improvement in PREVENT group were noted in several variables between baseline and 6-month follow-up but not sustained at 12-month follow-up. Of note, VO2 peak did not change over time in either group. Conclusion Impact of PREVENT on vascular risk factor reduction was more modest than anticipated, possibly because several outcome variables approximated normative values at baseline and training intensity may have been sub-optimal. Further investigation is warranted to determine when exercise and education programs are viable adjuncts to pharmaceutical management for reduction of risk factors for second stroke. Clinical Trial Registration-URL: http://www.clinicaltrials.gov . Unique identifier: #NCT00885456

Abstract W P130: Relationship Between Risk Factor Control and Vascular Events in the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tanya N Turan ◽  
Azhar Nizam ◽  
Michael J Lynn ◽  
Jean Montgomery ◽  
Colin P Derdeyn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Medical Management ◽  
Lower Risk ◽  
Intracranial Stenosis ◽  
Vascular Events ◽  
Risk Factor Control ◽  
Increased Risk ◽  
Aggressive Medical Management

Background and Purpose: Symptomatic intracranial stenosis patients with poorly controlled cholesterol and blood pressure had an increased risk of vascular events in WASID. Therefore, SAMMPRIS aggressive medical management protocols targeted these risk factors. We sought to determine if intensive risk factor control in SAMMPRIS resulted in lower risk of vascular events during follow-up. Methods: Data on 227 SAMMPRIS patients randomized to aggressive medical management alone were used for these analyses. Vascular risk factors were recorded at baseline, 30 days, and every 4 months. Additional follow-up and close-out visit data were also included. For each patient, values for all risk factor measures (from baseline until the time of an event) were averaged and dichotomized based on the risk factor target. Time to event curves for a vascular event (stroke, MI, and vascular death) were compared between subjects with and without risk factor control using the log-rank test and hazard ratios were calculated with Cox proportional hazards regression. Results: The univariate analyses are shown in the table. Subjects with mean follow-up SBP < 140 mm Hg (< 130 for diabetics), LDL < 70 mg/dL, and at least moderate exercise had lower risk of vascular events compared to those who did not achieve those targets. Control of other risk factors (HgA1c, smoking, non-HDL, and Body Mass Index) did not have a significant impact on outcome. Conclusions: Well controlled SBP and LDL during follow-up were predictors of lower vascular events in SAMMPRIS, confirming that SBP and LDL should be aggressively treated in patients with intracranial stenosis to prevent future vascular events. Exercise participation was also associated with fewer vascular events and should be strongly encouraged.

Abstract T MP105: Relationship Between Compliance With the Lifestyle Modification Program and Risk Factor Control in the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tanya N Turan ◽  
Azhar Nizam ◽  
Michael J Lynn ◽  
Jean Montgomery ◽  
Colin P Derdeyn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Medical Management ◽  
Lifestyle Modification ◽  
Recurrent Stroke ◽  
Risk Factor Control ◽  
Chi Square ◽  
Lifestyle Modification Program ◽  
Aggressive Medical Management

Background and Purpose: SAMMPRIS was the first vascular disease prevention trial to provide a commercially available lifestyle modification program to subjects to enhance risk factor control. We sought to determine the relationship between compliance with the lifestyle modification program and risk factor control in SAMMPRIS. Methods: SAMMPRIS aggressive medical management included a telephonic lifestyle modification program provided free of charge to all subjects (n=451) during their participation in the study. Subjects with < 3 expected lifestyle coaching calls were excluded from these analyses. Subjects with ≥ 78.5% of calls (median % of completed/expected calls) were considered Compliant (n=201). Subjects with < 78.5% and those who refused to participate were considered Noncompliant (n=200). Mean risk factor values or % in-target for each risk factor were compared between Compliant vs. Noncompliant subjects, using t-tests and chi-square tests. Risk factor changes from baseline to follow-up were compared between the groups to account for baseline differences between the groups. Results: As shown in the figure, Compliant subjects had better risk factor control throughout follow-up for LDL, SBP, HgA1c, non-HDL, non-smoking, and exercise than Noncompliant subjects, but there was no difference for BMI. Compliant subjects also had better control of LDL, non-HDL, and HgA1c at baseline. Both groups had some improvement in risk factors throughout the study (except for BMI), but after adjusting for baseline differences between the groups, Compliant subjects had a greater change from baseline than Noncompliant subjects for SBP at 24 months and HgA1c at 6 months. Conclusions: SAMMPRIS subjects who were compliant with the lifestyle modification program had better risk factor control during the study for almost all risk factors.

scholarly journals High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohort

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jonatan Fridolfsson ◽  
Christoph Buck ◽  
Monica Hunsberger ◽  
Joanna Baran ◽  
Fabio Lauria ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Body Mass Index ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Cross Sectional ◽  
Intensity Physical Activity

Abstract Background Physical activity (PA) during childhood is important for preventing future metabolic syndrome (MetS). To examine the relationship between PA and MetS in more detail, accurate measures of PA are needed. Previous studies have only utilized a small part of the information available from accelerometer measured PA. This study investigated the association between measured PA and MetS in children with a new method for data processing and analyses that enable more detailed interpretation of PA intensity level. Methods The association between PA pattern and risk factors related to MetS was investigated in a cross- sectional sample of children (n = 2592, mean age 10.9 years, 49.4% male) participating in the European multicenter I. Family study. The risk factors examined include body mass index, blood pressure, high-density lipoprotein cholesterol, insulin resistance and a combined risk factor score (MetS score). PA was measured by triaxial accelerometers and raw data was processed using the 10 Hz frequency extended method (FEM). The PA output was divided into an intensity spectrum and the association with MetS risk factors was analyzed by partial least squares regression. Results PA patterns differed between the European countries investigated, with Swedish children being most active and Italian children least active. Moderate intensity physical activity was associated with lower insulin resistance (R2 = 2.8%), while vigorous intensity physical activity was associated with lower body mass index (R2 = 3.6%), MetS score (R2 = 3.1%) and higher high-density lipoprotein cholesterol (R2 = 2.3%). PA of all intensities was associated with lower systolic- and diastolic blood pressure, although the associations were weaker than for the other risk factors (R2 = 1.5% and R2 = 1.4%). However, the multivariate analysis implies that the entire PA pattern must be considered. The main difference in PA was observed between normal weight and overweight children. Conclusions The present study suggests a greater importance of more PA corresponding to an intensity of at least brisk walking with inclusion of high-intense exercise, rather than a limited time spent sedentary, in the association to metabolic health in children. The methods of data processing and statistical analysis enabled accurate analysis and interpretation of the health benefits of high intensity PA that have not been shown previously.

Relationship between country income, socioeconomic factors and control of cardiovascular disease risk factors in patients with type 2 Diabetes: insights from the global DISCOVER registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Malik ◽  
H Chen ◽  
A Cooper ◽  
M Gomes ◽  
V Hejjaji ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Optimal Control ◽  
Risk Factor ◽  
Socioeconomic Factors ◽  
Funding Source ◽  
Risk Factor Control ◽  
Cv Disease

Abstract Background In patients with type 2 diabetes (T2D), optimal management of cardiovascular (CV) risk factors is critical for primary prevention of CV disease. Purpose To describe the association of country income and patient socioeconomic factors with risk factor control in patients with T2D. Methods DISCOVER is a 37-country, prospective, observational study of 15,983 patients with T2D enrolled between January 2016 and December 2018 at initiation of 2nd-line glucose-lowering therapy and followed for 3 years. In patients without known CV disease with sub-optimally controlled risk factors at baseline, we examined achievement of risk factor control (HbA1c &lt;7%, BP &lt;140/90 mmHg, appropriate statin) at the 3 year follow-up. Countries were stratified by gross national income (GNI)/capita, per World Bank report. We explored variability across countries in risk factor control achievement using hierarchical logistic regression models and examined the association of country- and patient-level economic factors with risk factor control. Results Among 9,613 patients with T2D but without CV disease (mean age 57.2 years, 47.9% women), 83.1%, 37.5%, and 66.3% did not have optimal control of glucose, BP, and statins, respectively, at baseline. Of these, 40.8%, 55.5%, and 28.6% achieved optimal control at 3 years of follow-up. There was substantial variability in achievement of risk factor control across countries (Figure) but no association of country GNI/capita on achievement of risk factor control (Table). Insurance status, which differed substantially by GNI group, was strongly associated with glycemic control, with no insurance and public insurance associated with lower odds of patients achieving HbA1c &lt;7%. Conclusions In a global cohort of patients with T2D, a substantial proportion do not achieve risk factor control even after 3 years of follow-up. The variability across countries in risk factor control is not explained by the GNI/capita of the country. Proportion of patients at goal Funding Acknowledgement Type of funding source: Private company. Main funding source(s): The DISCOVER study is funded by AstraZeneca

scholarly journals Relationship Between Meeting 24-Hour Movement Guidelines and Cardiometabolic Risk Factors in Children

2017 ◽  
Vol 14 (10) ◽  
pp. 779-784 ◽  
Author(s):  
Peter T. Katzmarzyk ◽  
Amanda E. Staiano
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Adipose Tissue ◽  
Subcutaneous Adipose Tissue ◽  
Cardiometabolic Risk ◽  
Vigorous Physical Activity ◽  
Density Lipoprotein ◽  
Cardiometabolic Risk Factors ◽  
Subcutaneous Adipose

Background:The purpose of this study was to evaluate the relationship between adherence to pediatric 24-hour movement guidelines (moderate to vigorous physical activity, sedentary behavior, and sleep) and cardiometabolic risk factors.Methods:The sample included 357 white and African American children aged 5–18 years. Physical activity, television viewing, and sleep duration were measured using questionnaires, and the 24-hour movement guidelines were defined as ≥60 minutes per day of moderate to vigorous physical activity on ≥5 days per week, ≤ 2 hours per day of television, and sleeping 9–11 hours per night (ages 5–13 y) or 8–10 hours per night (ages 14–18 y). Waist circumference, body fat, abdominal visceral and subcutaneous adipose tissue, blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and glucose were measured in a clinical setting.Results:A total of 26.9% of the sample met none of the guidelines, whereas 36.4%, 28.3%, and 8.4% of the sample met 1, 2, or all 3 guidelines, respectively. There were significant associations between the number of guidelines met and body mass index, visceral and subcutaneous adipose tissue, triglycerides, and glucose. There were no associations with blood pressure or high-density lipoprotein cholesterol.Conclusions:Meeting more components of the 24-hour movement guidelines was associated with lower levels of obesity and several cardiometabolic risk factors. Future efforts should consider novel strategies to simultaneously improve physical activity, sedentary time, and sleep in children.

Abstract P127: Racial Disparities in Risk Factor Control in Older Adults with Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Christina Parrinello ◽  
Ina Rastegar ◽  
Job G Godino ◽  
Michael D Miedema ◽  
Kunihiro Matsushita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Factor ◽  
Racial Disparities ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Tight Control ◽  
Risk Factor Control ◽  
Atherosclerosis Risk In Communities

Background: Racial disparities in risk factor control have been documented in middle-aged adults, but much less is known about older adults with diabetes. Our findings will inform clinical guidelines on appropriate risk factor control in older adults with diabetes. Methods: In 2011-13, 6,538 ARIC participants attended visit 5, and 4,988 provided data on all key covariates used in these analyses. Of these, 31% had diagnosed diabetes (N=1,561, 72% white, mean age=75 years) and were included in this study. Tight control of risk factors was defined according to American Diabetes Association guidelines: hemoglobin A1c <7%; low-density lipoprotein cholesterol <100 mg/dL; systolic blood pressure (BP) <140 mmHg and diastolic BP <80 mmHg. We evaluated risk factor control overall and by race. We used logistic regression and predictive margins to assess independent associations of race with tight risk factor control. Results: Among older adults with diabetes, 64% used glucose-lowering medication, 70% lipid-lowering medication and 82% BP-lowering medication. Only 5% of participants did not take medication for any of these risk factors. Tight control was observed in 72% for glucose, 64% for lipids and 70% for BP. Only 34% had tight control of all three. A higher proportion of whites than blacks consistently achieved tight control ( Figure ). In multivariable analyses of persons with diabetes who were treated for risk factors, racial disparities in tight control of lipids and BP remained significant: adjusted prevalence ratios and 95% CIs (white vs black) were 1.04 (0.91, 1.17) for glucose, 1.21 (1.08-1.34) for lipids, 1.15 (1.03-1.26) for BP, and 1.33 (0.95, 1.70) for tight control of all three risk factors. Conclusions: Our results highlight racial disparities in risk factor control in older adults with diabetes that were not explained by demographic or clinical characteristics. Further studies are needed to elucidate the determinants of disparities in risk factor control and strategies to address these.

Abstract T P388: Statin Use is Linked to Lower Risk of Recurrent Vascular Events among Ischemic Stroke Patients with Atrial Fibrillation

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Meng Lee ◽  
Yi-Ling Wu ◽  
Jeffrey L Saver ◽  
Jiann-Der Lee ◽  
Hui-Hsuan Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Recurrent Stroke ◽  
Stroke Patients ◽  
Antithrombotic Agent ◽  
Vascular Events ◽  
Index Stroke ◽  
Statin Use

Background: The efficacy of statin therapy in the prevention of recurrent stroke and major adverse cardiovascularevents (MACE) was clearly established by the SPARCL trial; but SPARCL excluded patients whose index stroke was due to a presumed cardioembolic mechanism. As such, it remains unclear whether statins are beneficial in cardioembolic stroke patients, particularly those with atrial fibrillation (AF). Objective: To evaluate the relationship between statin use and future vascular risk reduction among recent ischemic stroke patients with AF Methods: We analyzed the Taiwan National Health Insurance registry which comprises beneficiaries aged ≥ 18 years. Code ICD-9 was used to identify a primary hospitalization diagnosis of ischemic stroke and AF among subjects encountered between 2003 and 2009. Follow-up was from time of the index stroke to admission for recurrent stroke or myocardial infarction; withdrawal from the registry; and last medical claim before 1/1/2011. Patients were divided into 2 groups based on whether statin was prescribed (at least 30 days vs. never used) during the follow-up period. Patients were excluded if they did not take any antithrombotic agent within 30 days before an endpoint. Primary endpoint was MACE (composite of stroke and myocardial infarction) and a key secondary endpoint was any recurrent stroke. Multivariate-adjusted hazard ratio (HR) and 95% CI for the development of events were estimated using Cox models. Model was adjusted for baseline age, gender, hypertension, diabetes, prior stroke, prior myocardial infarction, hyperlipidemia, hospital level, and antithrombotic agent during follow-up. Results: Among 4455 eligible patients, mean age was 71 years and mean follow-up duration was 2.8 years.Compared to non-statin use, statin use was associated with a significantly lower occurrence of MACE (adjusted HR 0.84, 95% CI 0.72 to 0.99, P=0.04) and recurrent stroke (adjusted HR 0.82, 0.69 to 0.97, P=0.02). Statin use was also linked to lower ischemic stroke risk, but had neutral effects on intracranial hemorrhage and myocardial infarction. Conclusion: Among patients with an index ischemic stroke and AF, statin use is associated with a lower risk of recurrent vascular events including stroke.

Influence of time spent on TV viewing and vigorous intensity physical activity on cardiovascular biomarkers. The Inter 99 study

2007 ◽  
Vol 14 (5) ◽  
pp. 660-665 ◽  
Author(s):  
Mette Aadahl ◽  
Michael Kjær ◽  
Torben Jørgensen
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Density Lipoprotein ◽  
Tv Viewing ◽  
Intensity Physical Activity ◽  
Vigorous Intensity

Introduction Sedentary behaviour, especially TV viewing, has been identified as a possible risk factor for cardiovascular disease, whereas physical activity seems to protect against major cardiovascular risk factors: obesity, dyslipidemia and hypertension. The aim of this study was to explore the association between both time spent on TV viewing and vigorous intensity physical activity in relation to body mass index, waist circumference, waist/hip ratio, serum lipids and blood pressure. Methods A total of 1693 men and women, 33-64 years of age, from the 3-year follow-up of a population-based intervention study, The Inter 99 study, were included in this cross-sectional design. Information on TV viewing, physical activity and other lifestyle habits was obtained by self-report questionnaire. Associations between TV viewing/physical activity and biological cardiovascular risk factors were explored by multiple linear regression analyses. Results Data from 835 (51%) men and 805 (49%) women were included. Mean age was 50.8 years (33.0-64.6). Men had a higher overall physical activity score than women ( P < 0.0001). TV viewing was significantly, positively associated with waist/hip ratio ( P = 0.005), body mass index ( P = 0.03), triglycerides ( P = 0.005), low density lipoprotein cholesterol ( P = 0.03), total cholesterol ( P = 0.01), systolic ( P = 0.05) and diastolic blood pressure ( P = 0.03), but not with waist circumference and high density lipoprotein cholesterol (HDL). Engaging in vigorous intensity physical activity was associated with higher HDL ( P = 0.0006) and lower waist circumference ( P < 0.0001). Conclusion TV viewing and physical activity should be regarded as separate types of behaviour that relate to different cardiovascular disease risk factors. Eur J Cardiovasc Prev Rehabil 14:660-665 © 2007 The European Society of Cardiology

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