The purpose of this study was to examine the relationship between two sedentary behaviors (riding in a car and watching TV) and cardiovascular disease (CVD) mortality in men in the Aerobics Center Longitudinal Study. Participants were 7744 men (20-89 yr) initially free of CVD who returned a mail-back survey during 1982. Time spent watching TV and time spent riding in a car were reported. Mortality data were ascertained through the National Death Index until December 31, 2003. Cox regression analysis quantified the association between sedentary behaviors (hours per week watching TV, hours per week riding in a car, and total hours per week in these two behaviors) and CVD mortality rates. Three hundred and seventy-seven CVD deaths occurred during 21 yr of follow-up. After age adjustment, time riding in a car and combined time spent in these two sedentary behaviors were positively (P(trend) < 0.001) associated with CVD death. Men who reported >10 h x wk(-1) riding in a car or >23 h x wk(-1) of combined sedentary behavior had 82% and 64% greater risk of dying from CVD than those who reported <4 or <11 h x wk(-1), respectively. The pattern of the association did not materially change after multivariate adjustment. Regardless of the amount of sedentary activity reported by these men, being older, having normal weight, being normotensive, and being physically active were associated with a reduced risk of CVD death. In men, riding in a car and combined time spent in these two sedentary behaviors were significant CVD mortality predictors. In addition, high levels of physical activity were related to notably lower rates of CVD death even in the presence of high levels of sedentary behavior. Health promotion efforts targeting physically inactive men should emphasize both reducing sedentary activity and increasing regular physical activity for optimal cardiovascular health.
