Individuals who watch a lot of TV are at a greater risk for death caused by pulmonary embolism, a study by Japanese researchers suggests.
In the cohort study, published as a Research Letter in Circulation, those who watched more than 5 hours of television a day were 2.5 times more likely to die of deep vein thrombosis or a pulmonary embolism when compared with those who watched less than that amount (95% CI 1.2-5.3).
Hiroyasu Iso, MD, PhD, MPH, president of the Japan Epidemiological Association and professor of social environment medicine at Osaka University Graduate School of Medicine, and colleagues used data from the population-based Japanese Collaborative Cohort Study that started between 1988 and 1990 in 45 regions of Japan and includes 110,585 people age 40 to 79.
Asked to comment on the study, Richard Becker, MD, director at the University of Cincinnati Heart, Lung and Vascular Institute, told MedPage Today: "There are medications and other strategies to minimize the risk of pulmonary embolism in these settings; however, from a public health perspective, activity represents a widely implementable health measure."
Iso offered some advice on how to mitigate the severity of the problem in a press release from the American Heart Association, suggesting that individuals who watch a lot of TV do more standing, stretching, flexing of leg muscles, and walking around while they watch TV in order to counterbalance the prolonged amounts of time spent sitting down.
He and his co-authors found that each additional 2 hours of time spent watching TV was linked to a 40% increase in death due to pulmonary embolism (HR 1.4, 95% CI 1.0-1.8).
Venous stasis is most likely the mechanism that causes blood clots to eventually reach the lungs, the researchers explained, adding that factors such as obesity, diabetes, and smoking status were not significantly associated with pulmonary embolism in the study, which is believed to be the first of its kind. There had been case series that found a link between pulmonary embolism or deep vein thrombosis after prolonged television watching, but no prospective studies had examined the association between time spent watching TV and the risk of mortality from pulmonary embolism, the team noted.
The new study included 86,024 participants, about 60% of whom were female. The baseline information -- including the number of hours per day each person spent watching TV -- was collected between 1988 and 1990, and participants were followed up until 2009. In that time, 59 deaths caused by pulmonary embolism were recorded. The participants were divided into three categories based on how many hours per day they spent watching TV: 2.5 , 2.5-4.9, and more than 5.0 hours a day.
The rate per 100,00 person-years of death due to pulmonary embolism for those who watched more than 5 hours per day was almost double what it was for those who watched between 2.5 and 5 hours a day: 8.2 for the > 5 category, and 4.8 for the 2.5-4.9 category.
More current research is needed to assess the latest causes of sedentary lifestyles, Iso and colleagues said. For example, in the past, pulmonary embolism risk was shown to be associated with long-distance travel, in addition to long amounts of time spent sitting at home. This study confirms the results of these previous ones, further proving that there is a link between sitting and mortality due to pulmonary embolism, the team said.
Some of the limitations of the study included possible under-reporting of deaths caused by pulmonary embolism and possible inaccuracy in the reporting of the hours per day spent watching TV. The authors also noted that if the data were collected now, the use of computers and smartphones might add a whole new dimension to the study: "Time sitting before personal computers or smartphones may be replacing time spent watching television," they hypothesized.
Becker noted that the three main causes of pulmonary embolism are aging, obesity, and inactivity. "The epidemic of inactivity is sending a powerful reminder about our roots. It is time for action, through physical activity," he concluded.
Support for the study was provided by Osaka University Graduate School of Medicine, the University of Tsukuba, Fujita Health University School of Medicine, the University of Niigata Prefecture, and the Hokkaido University Graduate School of Medicine.
No conflicts of interest were reported.
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