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. (C) 2008 Elsevier Inc. All rights reserved.