Comparative risk assessment modeling of cardiovascular and all-cause burden attributable to sitting time and physical inactivity: evidence from Argentina.

BACKGROUND: Although there is evidence that sitting time (ST) and insufficient physical activity (PA) are associated with premature mortality, the burden of cardiovascular disease (CVD) and all-cause mortality (ACM) attributable to the combined effects of ST and PA in counterfactual scenarios is limited.

METHODS: Potential impact fractions (PIFs) were used to calculate premature deaths (PDs) and disability-adjusted life years (DALYs). Cause-eliminated life tables were utilized to estimate health-adjusted life expectancy (HALE) gains. Monte Carlo simulations were performed for uncertainty analysis.

RESULTS: The theoretical minimum risk exposure level (ST < 4 $\mathrm{h} \cdot{\mathrm{d}}^{-1}$, PA > 65 $\mathrm{min} \cdot{\mathrm{d}}^{-1}$) could prevent 16.7% of CVD deaths and 12.3% of all-cause deaths annually. This would save 669 to 2,630 DALYs per 100,000 and increase healthy life years by 0.57 to 2.94. Increasing PA to > 65 $\mathrm{min} \cdot{\mathrm{d}}^{-1}$ while maintaining ST could yield gains in HALE from 0.49 (CVD) to 2.60 (ACM) years. Reducing ST to < 4 $\mathrm{h}\cdot{\mathrm{d}}^{-1}$ while keeping PA constant could lead to gains in HALE from 0.07 (CVD) to 0.34 (ACM) years. A 50% reduction in suboptimal ST (≥ 4 $\mathrm{h}\cdot{\mathrm{d}}^{-1}$) doubled HALE gains, ranging from 0.11 to 0.63 years.

CONCLUSIONS: Public health decision-makers should prioritize vulnerable populations, including older adults and individuals with inadequate PA levels.