Association between TV viewing and heart disease mortality: observational study using negative control outcome

Area of Science:

• Epidemiology
• Public Health
• Cardiovascular Disease Research

Background:

• Sedentary behavior, specifically television (TV) viewing, is a suspected risk factor for cardiovascular disease.
• The association between TV viewing and heart disease mortality requires further investigation to rule out confounding factors.

Purpose of the Study:

• To investigate whether confounding variables explain the association between television viewing and heart disease mortality.
• To utilize a negative control outcome to assess the impact of confounding on the TV viewing-heart disease link.

Main Methods:

• Utilized data from the UK Biobank study, including 479,658 participants.
• Measured television viewing via self-report and tracked ischaemic heart disease (IHD) deaths and accidental deaths over a mean of 10.4 years.
• Analyzed associations between TV viewing and outcomes, adjusting for potential confounders such as smoking, diet, obesity, and physical inactivity.

Main Results:

• TV viewing was associated with both IHD and accidental deaths in unadjusted models.
• Associations for both outcomes were attenuated after adjusting for confounders.
• The hazard ratios for IHD and accidental deaths converged significantly after confounder adjustment.

Conclusions:

• The observed association between television viewing and heart disease mortality is likely driven by confounding lifestyle factors.
• The use of a negative control outcome supports the hypothesis that confounding, not TV viewing itself, explains the association with heart disease.