Sedentary time and peripheral artery disease: The Hispanic community health study/study of Latinos

Abstract Background Experimental evidence suggests sedentary time (ST) may contribute to cardiovascular disease by eliciting detrimental hemodynamic changes in the lower limbs. However, little is known about objectively-measured ST and lower extremity peripheral artery disease (PAD). Methods We included 7609 Hispanic/Latinos (ages 45–74) from the Hispanic Community Health Study/Study of Latinos. PAD was measured using the ankle brachial index (ABI ≤ 0.9). ST was measured using accelerometry. We used multivariable logistic regression to assess associations of quartiles of ST and PAD then used the same logistic models with restricted cubic splines (RCS) to investigate continuous non-linear associations of ST and PAD. Models were sequentially adjusted for traditional PAD risk factors, leg pain, and moderate-vigorous intensity physical activity (MVPA). Results Median ST was 12.2 hours/day and 5.4% of individuals had PAD. Fully adjusted RCS models accounting for traditional PAD risk factors, leg pain, and MVPA, ST had a significant overall (P = .048) and non-linear (P = .024) association with PAD. A threshold effect was seen such that time spent above median ST was associated with higher odds of PAD. That is, compared to median ST, 1, 2 and 3 hours above median ST was associated with a PAD OR of 1.16 (95% CI: 1.02–1.31), 1.44 (1.06–1.94) and 1.80 (1.11–2.90), respectively. Conclusions Among Hispanic/Latino adults, ST was associated with higher odds of PAD, independent of leg pain, MVPA, and traditional PAD risk factors. Notably, we observed a threshold effect such that these associations were only observed at the highest levels of ST.