Television viewing, leisure-time exercise and acute coronary syndrome in transitional Albania

OBJECTIVE: To assess the association of leisure-time exercise and television (TV) viewing, a sedentary marker, with acute coronary syndrome (ACS) in Albania, a transitional country in Southeast Europe. METHODS: A population-based case-control study was conducted among Tirana residents in 2003-2006. Information on leisure-time exercise (transformed into kilocalories of energy expenditure) and daily hours of TV viewing was obtained by interviewer-administered questionnaire. 460 non-fatal ACS patients (368 men, 92 women) and 628 coronary heart disease-free controls (413 men, 215 women) were studied. RESULTS: Adjusted for socio-demographic characteristics, conventional coronary risk factors and leisure-time exercise, TV viewing was associated with ACS in women (OR=1.66, 95%CI=1.12-2.46 per hour/day viewing), but not in men (OR=0.93, 95%CI=0.81-1.07; P for sex-interaction=0.02). A low level of leisure-time exercise (adjusted also for TV viewing) was associated with ACS similarly in men and women (pooled sexes OR=2.03, 95%CI=1.29-3.22 for bottom vs top tertile of energy expenditure). CONCLUSIONS: Leisure-time inactivity is confirmed as an important risk factor for ACS also in Southeastern Europe. TV viewing may be an informative coronary risk marker in transitional societies, especially in women.