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The Effects of Acute Exposure to Prolonged Sitting, with and Without Interruption, on Peripheral Blood Pressure Among Adults: A Systematic Review and Meta-Analysis

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Abstract

Background

Previous reviews have shown that exposure to acute prolonged sitting can have detrimental effects on several cardiovascular and cardiometabolic health markers. However, to date, there has been no synthesis of peripheral blood pressure data (including systolic blood pressure, diastolic blood pressure and mean arterial pressure), an important and translatable marker of cardiovascular health. Similarly, no previous study has consolidated the effects of sitting interruptions on peripheral blood pressure.

Objectives

We aimed to (1) assess the effect of exposure to acute prolonged sitting on peripheral blood pressure and (2) determine the efficacy of sitting interruption strategies as a means of offsetting any negative effects. Subgroup analyses by age and interruption modality were performed to explore heterogeneity.

Data Sources

Electronic databases (PubMed, Web of Science and, SPORTDiscus) were searched from inception to March 2021. Reference lists of eligible studies and relevant reviews were also screened.

Study Selection

Inclusion criteria for objective (1) were: (i) peripheral blood pressure was assessed non-invasively in the upper limb pre-sitting and post-sitting; (ii) studies were either randomised controlled, randomised crossover or quasi-experimental pre-test vs post-test trials; (iii) the sitting period was ≥ 1 h; (iv) pre-sitting and post-sitting measures were performed in the same posture; and (v) participants were adults (aged ≥ 18 years), free of autonomic or neuromuscular dysfunction. Additional criteria for objective (2) were: (i) the interruption strategy was during the sitting period; (ii) there was an uninterrupted sitting control condition; and (iii) the interruption strategy must have involved participants actively moving their upper or lower limbs.

Appraisal and Synthesis Methods

In total, 9763 articles were identified, of which 33 met inclusion criteria for objective (1). Of those articles, 22 met inclusion criteria for objective (2). Weighted mean difference (WMD), 95% confidence intervals (95% CI), and standardised mean difference (SMD) were calculated for all trials using inverse variance heterogeneity meta-analysis modelling. Standardised mean difference was used to determine the magnitude of effect, where < 0.2, 0.2, 0.5 and 0.8 were defined as trivial, small, moderate and large, respectively.

Results

(1) Prolonged uninterrupted sitting resulted in trivial and small significant increases in systolic blood pressure (WMD = 3.2 mmHg, 95% CI 0.6 to 5.8, SMD = 0.14) and mean arterial pressure (WMD = 3.3 mmHg, 95% CI 2.2 to 4.4, SMD = 0.37), respectively, and a non-significant trivial increase in diastolic blood pressure. Subgroup analyses indicated that the increases in systolic blood pressure and mean arterial pressure were more pronounced in younger age groups. (2) Interrupting bouts of prolonged sitting resulted in significantly lower systolic blood pressure (WMD =  − 4.4 mmHg, 95% CI − 7.4 to − 1.5, SMD = 0.26) and diastolic blood pressure (WMD =  − 2.4 mmHg, 95% CI − 4.5 to − 0.3, SMD = 0.19) compared with control conditions, particularly when using aerobic interruption strategies.

Conclusions

Exposure to acute prolonged uninterrupted sitting results in significant increases in systolic blood pressure and mean arterial pressure, particularly in younger age groups. Regularly interrupting bouts of prolonged sitting, particularly with aerobic interruption strategies may reduce negative effects.

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Authors and Affiliations

  1. School of Sport and Exercise, University of Gloucestershire, Gloucester, GL2 9HW, UK

    Craig Paterson, Simon Fryer, Keeron Stone & Louise Turner

  2. Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Gabriel Zieff & Lee Stoner

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  1. Craig Paterson
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  2. Simon Fryer
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  4. Gabriel Zieff
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  5. Louise Turner
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  6. Lee Stoner
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Correspondence to Craig Paterson.

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Funding

No sources of funding were used to assist in the preparation of this article.

Conflicts of interest/competing interests

Craig Paterson, Simon Fryer, Keeron Stone, Gabriel Zieff, Louise Turner and Lee Stoner declare that they have no conflicts of interest relevant to the content of this review.

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Availability of data and material

The data analysed for this meta-analysis and the corresponding R script for analysis are available from the corresponding author on reasonable request.

Authors’ contributions

Conceptualisation: CP and LS. Literature search: CP and LS. Quality assessment: CP, KS and SF. Data extraction: CP and GZ. Data analysis: CP and LS. CP, SF and KS wrote the first draft of the manuscript. GZ, LS and LT revised the original manuscript. All authors read and approved the final manuscript.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 Electronic Supplementary Material Appendix S1 Key words for literature search (DOCX 11 kb)

40279_2021_1614_MOESM2_ESM.pdf

Supplementary file2 Electronic Supplementary Material Appendix S2 Forest plot for meta-analysis of the effect of uninterrupted sitting on systolic blood pressure (PDF 7 kb)

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Supplementary file3 Electronic Supplementary Material Appendix S3 Forest plot for meta-analysis of the effect of uninterrupted sitting on diastolic blood pressure (PDF 6 kb)

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Supplementary file4 Electronic Supplementary Material Appendix S4 Forest plot for meta-analysis of the effect of uninterrupted sitting on mean arterial pressure (PDF 7 kb)

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Supplementary file5 Electronic Supplementary Material Appendix S5 Forest plot for meta-analysis of the effect of interrupted sitting on systolic blood pressure (PDF 7 kb)

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Supplementary file6 Electronic Supplementary Material Appendix S6 Forest plot for meta-analysis of the effect of interrupted sitting on diastolic blood pressure (PDF 7 kb)

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Supplementary file7 Electronic Supplementary Material Appendix S7 Subgroup analysis of mean arterial pressure, systolic, and diastolic blood pressure by assessment type (DOCX 15 kb)

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Paterson, C., Fryer, S., Stone, K. et al. The Effects of Acute Exposure to Prolonged Sitting, with and Without Interruption, on Peripheral Blood Pressure Among Adults: A Systematic Review and Meta-Analysis. Sports Med 52, 1369–1383 (2022). https://doi.org/10.1007/s40279-021-01614-7

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  • DOI: https://doi.org/10.1007/s40279-021-01614-7

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