Abstract
Introduction: Previous studies have linked TV watching with increased venous thromboembolism (VTE) risk independent of physical activity or other VTE risk factors. This finding warrants replication in a contemporary and geographically diverse cohort. Hypothesis: We hypothesized that TV watching is associated with increased hazard of VTE independent of physical activity and other VTE risk factors. Methods: From 2003-2007 REGARDS enrolled 30,239 participants aged 45+ years, who were surveyed for baseline TV viewing behavior and followed for VTE events. Daily TV viewing was categorized as <2 hours, 2 to 4 hours, and 4+ hours. Physical activity was classified as high, medium or low based on weekly number of times participants reported activity sufficient to work up a sweat. Excluding those with prebaseline VTE, log-rank tests and Cox proportional hazards models were used to describe associations, adjusting for physical activity, age, sex, BMI, race, region, C-reactive protein (CRP) and estimated glomerular filtration rate (EGFR). In a sensitivity analysis, missing data were imputed by multiple imputation with chained equations. Results: TV viewing was not associated with increased VTE incidence by the log-rank test (p=0.33). In multivariable models shown in Table, greater TV watching did not increase VTE risk. In the complete case and imputation analyses, established VTE risk factors (older age, male sex, obesity, and CRP) were strongly associated with VTE. Depending on the model, high or medium physical activity was either significantly protective or trended towards protective against VTE (Table). Conclusions: In this contemporary cohort, in contrast to earlier studies, TV watching was not associated with VTE risk after accounting for confounders including obesity and physical activity. Traditional risk factors were associated with VTE risk suggesting this is not a cohort-specific issue. Findings could be due to differences in risk factor profiles in older and newer studies or differences in measurements of TV watching.
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