Standing does ‘not offset an otherwise sedentary lifestyle,’ may create circulatory issues

Key takeaways:

• Standing for more than 10 hours daily corresponded to increased risk for orthostatic circulatory disease.
• Sitting may be tied to a greater risk for CVD, whereas standing may not.

Standing did not improve cardiovascular health when compared with sitting, results from a cohort study published in the International Journal of Epidemiology showed.

Instead, standing may heighten the risks for several circulatory issues, such as deep vein thrombosis, whereas sitting for long periods of time may lead to higher risks for both CVD and orthostatic circulatory disease.

“The key takeaway is that standing for too long will not offset an otherwise sedentary lifestyle and could be risky for some people in terms of circulatory health,” Matthew N. Ahmadi, PhD, from the faculty of medicine and health at the University of Sydney in Australia and study lead author, said in a press release. “We found that standing more does not improve cardiovascular health over the long term and increases the risk of circulatory issues.”

According to Ahmadi and colleagues, it has been suggested that decreasing sitting time and increasing standing time “may improve surrogate cardiovascular outcomes such as metabolic markers,” but research on health outcomes resulting from this “are very scarce,” they wrote.

The study analyzed the accelerometer data of 83,013 adults (mean age, 61 years; 55.6% women) from the U.K. Biobank to determine links between time spent sitting, standing and being stationary with risks for major CVD and orthostatic circulatory disease.

Researchers defined major CVD as stroke, heart failure and coronary heart disease, whereas orthostatic circulatory disease included orthostatic hypotension, varicose veins and chronic venous insufficiency.

During a follow-up period of 6.9 years, 6,829 CVD and 2,042 orthostatic circulatory disease cases occurred in the cohort.

Ahmadi and colleagues noted that the risk for orthostatic circulatory disease increased by 22% every additional hour when stationary time exceeded 12hours a day (HR = 0.22; 95% CI, 0.16-0.29).

Every additional hour over 10hours of sitting a day corresponded with a 26% higher orthostatic circulatory disease risk (HR = 0.26; 95% CI, 0.18-0.36), whereas results showed a link between standing more than 2 hours a day and an 11% higher risk for every additional 30 minutes (HR = 0.11; 95% CI, 0.05-0.18).

Meanwhile, the risk for major CVD increased by an average of 13% per hour when stationary time exceeded 12hours a day (HR = 0.13; 95% CI, 0.1-0.16).

Sitting time corresponded with a 15% higher risk for major CVD per extra hour that exceeded over 10 hours a day (HR = 0.15; 95% CI, 0.11-0.19).

Standing time did not correspond to any increase in major CVD risk.

The researchers explained that there may be possible mechanisms behind the CVD associations “that are unique to sitting.”

“For example, the lower cumulative energy expenditure of sitting and the muscular and musculoskeletal system engagement during standing may partly explain the differential effects of the two postures,” they wrote.

Ahmadi and colleagues acknowledged some study limitations, such as possible misclassification of movement and posture.

Ultimately, “for people who sit for long periods on a regular basis, including plenty of incidental movement throughout the day and structured exercise may be a better way to reduce the risk [for] CVD,” Emmanuel Stamatakis, PhD, a professor at the University of Sydney and study co-author, said in the release. “Take regular breaks, walk around, go for a walking meeting, use the stairs, take regular breaks when driving long distances, or use that lunch hour to get away from the desk and do some movement.”

References:

• Ahmadi M, et al. Int J Epidemiol. 2024;doi:10.1093/ije/dyae136.
• Standing more may not reduce cardiovascular disease risk, could increase circulatory disease. Available at: https://www.sydney.edu.au/news-opinion/news/2024/10/17/standing-more-may-not-reduce-cardiovascular-disease-risk--could-.html. Published Oct. 17, 2024. Accessed Oct. 22, 2024.