Idling Toward Death from MedPage Today

By Todd Neale, Staff Writer, MedPage Today
Sitting around too much in one's spare time appears to increase the risk of dying,regardless of physical activity, researchers found.
Among more than 120,000 adults, those who sat more than six hours a day in their leisure time were significantly more likely to die in a 14-year period than those who sat less than three hours (P<0.0001), According to Alpa Patel, PhD, of the American Cancer Society in Atlanta, and colleagues.
The association was stronger in women (RR 1.34, 95% CI 1.25 to 1.44)than in men (RR 1.17, 95% CI 1.11 to 1.24), the researchers reported online in the American Journal of Epidemiology.

The findings were independent of physical activity levels, body mass index, smoking, and several other factors contributing to mortality risk.
According to the researchers, sedentary time may be related to mortality risk because sitting may be associated with other unhealthy behaviors, like excessive eating. In addition, sitting too much could have adverse metabolic effects.
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HDL Loses Power After LDL Lowering MedPage Today

By Charles Bankhead, Staff Writer, MedPage Today

The predictive value of HDL cholesterol all but disappeared with treatment-induced low levels of LDL, according to a new analysis of data from a large trial of lipid-lowering therapy.

Among patients treated with rosuvastatin (Crestor), the usual inverse association between HDL levels and vascular risk lost its statistical significance. Neither baseline (P=0.82) nor on-treatment (P=0.97) HDL levels predicted the risk of clinical events, Paul M. Ridker, MD, of Harvard, and colleagues reported online in The Lancet.

In contrast, HDL levels in placebo-treated patients had a significant association with subsequent events both at baseline (P=0.0039) and during randomized treatment (P=0.0047).

"Our data should not reduce enthusiasm for measurement of HDL-cholesterol concentration as part of an initial cardiovascular risk assessment," Ridker and his co-authors wrote in conclusion. "As shown here among those allocated to placebo, HDL cholesterol was a powerful inverse risk predictor.

"However, these primary prevent data and recent secondary prevention data from [other] trials provide little evidence to support the hypotheses that HDL cholesterol levels predict risk of vascular events in the setting of high-dose statin therapy."

In multiple randomized clinical trials, statin therapy has consistently led to large, statistically significant reductions in cardiovascular events. The benefits have been observed in both primary- and secondary-prevention trials, the authors wrote.

However, in every trial, residual risk has remained among patients assigned to statin therapy. One possible explanation for the residual risk is low levels of HDL.

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