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The Effect of Sitting Duration on Peripheral Blood Pressure Responses to Prolonged Sitting, With and Without Interruption: A Systematic Review and Meta-Analysis

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Abstract

Background

A previous meta-analysis reported that: (i) an acute bout of prolonged uninterrupted sitting induces a significant increase in peripheral blood pressure (BP) and (ii) the increase in BP can be offset by interrupting the sitting bout with light aerobic activities such as walking. However, the temporal association between prolonged uninterrupted sitting and BP was not determined. A better understanding of temporality, for example, how long it takes BP to increase, will assist in prescribing sitting interruption strategies.

Objectives

We aimed to determine: (1) the temporal association between the duration of uninterrupted sitting and BP and (2) whether regular sitting interruptions moderate the association between uninterrupted sitting and BP.

Data Sources

Electronic databases (PubMed, Web of Science, SPORTDiscus) were searched from inception to July 2022. Reference lists of eligible studies and relevant reviews were also screened.

Study Selection

Inclusion criteria for objective (1) were: (i) participants aged ≥ 18 years; (ii) a prolonged sitting bout ≥ 1 h; and (iii) peripheral BP measurements (systolic BP, diastolic BP, and/or mean arterial pressure) at more than two timepoints during the sitting bout. Additional criteria for objective (2) were: (i) the sitting interruption strategy was implemented during the sitting bout (i.e., not prior to engaging in sitting) and (ii) the study included a control (uninterrupted sitting) condition or group.

Appraisal and Synthesis Methods

There were 1555 articles identified, of which 33 met inclusion criteria for objective (1). Of those articles, 20 met inclusion criteria for objective (2). To investigate the effect of sitting duration on the BP response, unstandardized b coefficients (mmHg/h) and 95% confidence intervals (CIs) were calculated using a three-level mixed-effect meta-regression.

Results

Increased sitting duration was positively associated with systolic BP (b = 0.42 mmHg/h, 95% CI 0.18–0.60), diastolic BP (b = 0.24 mmHg/h, 95% CI 0.06–0.42), and mean arterial pressure (b = 0.66 mmHg/h, 95% CI 0.36–0.90). In trials where sitting was interrupted, there was a significant decrease in systolic BP (b = − 0.24 mmHg/h, 95% CI − 0.42 to − 0.06) and diastolic BP (b = − 0.24 mmHg/h, 95% CI − 0.42 to − 0.12), and a non-significant change in mean arterial pressure (p = 0.69).

Conclusions

Increased uninterrupted sitting duration results in greater increases in BP; however, regularly interrupting sitting may offset negative effects.

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Correspondence to Nathan T. Adams.

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This work was supported by the National Heart, Lung, and Blood Institute Grants R01 HL157187 and R01 HL162805A (both to Lee Stoner).

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Nathan T. Adams, Craig Paterson, Simon Higgins, Jillian Poles, and Lee Stoner have no conflicts of interest that are directly relevant to the content of this review.

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

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Conceptualization: NA, CP, and LS. Literature search: NA and JP. Quality assessment: NA and JP. Data extraction: NA and JP. Data analysis: NA and CP. NA and CP wrote the first draft of the manuscript. SH, JP, and LS revised the original manuscript. All authors read and approved the final manuscript.

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Adams, N.T., Paterson, C., Poles, J. et al. The Effect of Sitting Duration on Peripheral Blood Pressure Responses to Prolonged Sitting, With and Without Interruption: A Systematic Review and Meta-Analysis. Sports Med 54, 169–183 (2024). https://doi.org/10.1007/s40279-023-01915-z

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